AIM: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias. METHODS: We included 123 patients with symptomatic frequent premature ventricular outflow tract contractions who underwent successful catheter ablation (70 male, 53 female; mean age 46.2 ± 13.9 years, 61 RVOT, 62 LVOT origins). S-R difference in V1-V2 was calculated with this formula on the 12-lead surface ECG: (V1S + V2S) - (V1R + V2R). Conventional ablation was performed in 101 (82.1%) patients, CARTO electroanatomic mapping system was used in 22 (17.9%) patients. RESULTS: V1-2 SRd was found to be significantly lower for LVOT origins than RVOT origins (p < .001). The cutoff value of V1-2 SRd obtained by ROC curve analysis was 1.625 mV for prediction of RVOT origin (sensitivity: 95.1%, specificity: 85.5%, positive predictive value: 86.5%, negative predictive value: 94.5%). The area under the curve (AUC) was 0.929 (p < .001). CONCLUSION: S-R difference in V1-V2 is a novel and simple electrocardiographic criterion for accurately differentiating RVOT from LVOT sites of ventricular arrhythmia origins. The use of this simple ECG measurement could improve the accuracy of OTVA localization, could be beneficial for decreasing ablation duration and radiation exposure. Further studies with larger patient population are needed to verify the results of this study.
AIM: The correct estimation of the VA origin as RVOT or LVOT results in reduced ablation duration reduced radiation exposure and decreased number of vascular access. In our study, we aimed to detect the predictive value of S-R difference in V1-V2 for differentiating the left from right ventricular outflow tract arrhythmias. METHODS: We included 123 patients with symptomatic frequent premature ventricular outflow tract contractions who underwent successful catheter ablation (70 male, 53 female; mean age 46.2 ± 13.9 years, 61 RVOT, 62 LVOT origins). S-R difference in V1-V2 was calculated with this formula on the 12-lead surface ECG: (V1S + V2S) - (V1R + V2R). Conventional ablation was performed in 101 (82.1%) patients, CARTO electroanatomic mapping system was used in 22 (17.9%) patients. RESULTS: V1-2 SRd was found to be significantly lower for LVOT origins than RVOT origins (p < .001). The cutoff value of V1-2 SRd obtained by ROC curve analysis was 1.625 mV for prediction of RVOT origin (sensitivity: 95.1%, specificity: 85.5%, positive predictive value: 86.5%, negative predictive value: 94.5%). The area under the curve (AUC) was 0.929 (p < .001). CONCLUSION: S-R difference in V1-V2 is a novel and simple electrocardiographic criterion for accurately differentiating RVOT from LVOT sites of ventricular arrhythmia origins. The use of this simple ECG measurement could improve the accuracy of OTVA localization, could be beneficial for decreasing ablation duration and radiation exposure. Further studies with larger patient population are needed to verify the results of this study.
Authors: Brian P Betensky; Robert E Park; Francis E Marchlinski; Matthew D Hutchinson; Fermin C Garcia; Sanjay Dixit; David J Callans; Joshua M Cooper; Rupa Bala; David Lin; Michael P Riley; Edward P Gerstenfeld Journal: J Am Coll Cardiol Date: 2011-05-31 Impact factor: 24.094
Authors: Arash Arya; Yan Huo; Fredrick Frogner; Ulrike Wetzel; Philipp Sommer; Thomas Gaspar; Sergio Richter; Christopher Piorkowski; Gerhard Hindricks Journal: J Cardiovasc Electrophysiol Date: 2011-02-21
Authors: Rupa Bala; Fermin C Garcia; Mathew D Hutchinson; Edward P Gerstenfeld; Sandhya Dhruvakumar; Sanjay Dixit; Joshua M Cooper; David Lin; John Harding; Michael P Riley; Erica Zado; David J Callans; Francis E Marchlinski Journal: Heart Rhythm Date: 2009-11-17 Impact factor: 6.343
Authors: Marco V Mariani; Agostino Piro; Domenico G Della Rocca; Giovanni B Forleo; Naga Venkata Pothineni; Jorge Romero; Luigi Di Biase; Francesco Fedele; Carlo Lavalle Journal: Arrhythm Electrophysiol Rev Date: 2021-04
Authors: Ruben Doste; Miguel Lozano; Guillermo Jimenez-Perez; Lluis Mont; Antonio Berruezo; Diego Penela; Oscar Camara; Rafael Sebastian Journal: Front Physiol Date: 2022-08-12 Impact factor: 4.755