Modified Precordial Lead R-Wave Deflection Interval Predicts Left- and Right-Sided Idiopathic Outflow Tract Ventricular Arrhythmias
| Autor: | Alex J.A. McLellan, A. Al-Kaisey, Elaine Lui, Geoffrey Lee, Saurabh Kumar, J. Lipton, Peter M. Kistler, Mukund A. Prabhu, Ramanathan Parameswaran, Simon Binny, Paul B. Sparks, Joseph B. Morton, Bhupesh Pathik, David Chieng, S. Joseph, Robert D. Anderson, Subodh B Joshi, Joshua Hawson, H. Sugumar, Jonathan M. Kalman, Timothy Campbell |
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| Rok vydání: | 2020 |
| Předmět: |
Tachycardia
medicine.medical_specialty Heart Ventricles medicine.medical_treatment Catheter ablation Precordial examination 030204 cardiovascular system & hematology Ventricular tachycardia Electrocardiography 03 medical and health sciences QRS complex 0302 clinical medicine Precordial lead Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine medicine.diagnostic_test business.industry Arrhythmias Cardiac Middle Aged medicine.disease Catheter Ablation Tachycardia Ventricular cardiovascular system Cardiology Female Outflow medicine.symptom business |
| Zdroj: | JACC: Clinical Electrophysiology. 6:1405-1419 |
| ISSN: | 2405-500X |
| DOI: | 10.1016/j.jacep.2020.07.011 |
| Popis: | This study evaluated if modifying electrocardiographic (ECG) precordial leads to a higher intercostal position improved the accuracy of outflow tract ventricular arrhythmia (OTVA) localization.Precordial ECG prediction algorithms that use a standard lead configuration localize OTVA with variable accuracy.Patients who underwent OTVA ablation were prospectively enrolled to have a standard and modified (high) precordial ECG. R- and S-wave amplitudes and intervals were measured to develop an algorithm that differentiated the right ventricular outflow tract (RVOT) and the left ventricular outflow tract (LVOT) with high accuracy-the modified lead R-wave deflection interval (RWDI). This interval was defined from the earliest QRS onset (using all modified leads) to the lead with longest R-wave deflection. The RWDI was compared with all other ECG algorithms.A total of 50 patients (38 women; mean age 51 ± 17 years) had successful catheter ablation for OTVA (RVOT 60%, LVOT 40%). The modified lead RWDI was significantly shorter in the RVOT group (18.5 ms, interquartile range 25th to 75th percentile [IQRThe modified lead RWDI is a simple, easily interpretable algorithm that can potentially differentiate a right- or left-sided origin of OTVA with high accuracy. |
| Databáze: | OpenAIRE |
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