Electrocardiographic localization of ventricular arrhythmias successfully ablated from the distal great cardiac vein

Autor:	Roy M. John, Aditi S Vaishnav, Stavros E. Mountantonakis, Apoor Patel, Kristie M Coleman, Beom Soo Kim, David W. Chang, Bruce G. Goldner, James Gabriels, Haisam Ismail, Stuart Beldner, Raman Mitra, Kyle Maisel, Jonathan Willner, Laurence M. Epstein, Mohammad Qasim Khan
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty medicine.medical_treatment Heart Ventricles Catheter ablation Precordial examination 030204 cardiovascular system & hematology QT interval Great cardiac vein Ventricular contraction 03 medical and health sciences Electrocardiography 0302 clinical medicine Physiology (medical) Internal medicine medicine Ventricular outflow tract Humans 030212 general & internal medicine business.industry Coronary Sinus Middle Aged Ablation Ventricular Premature Complexes Highly sensitive Cardiology Catheter Ablation Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine business
Zdroj:	Journal of cardiovascular electrophysiologyREFERENCES. 31(10)
ISSN:	1540-8167
Popis:	Background Idiopathic ventricular arrhythmias (IVAs) from the left ventricular (LV) summit may be successfully ablated from the distal great cardiac vein (dGCV). Using a 12-lead electrocardiogram (ECG) to localize IVAs that can be ablated from the dGCV is valuable for ablation planning. Objective To determine if a "w" wave, a notch in the Q wave in lead I, and other ECG features can identify IVAs that can be successfully ablated from the dGCV. Methods We reviewed outflow tract premature ventricular contraction (PVC) ablations performed at two centers between September 2010 and June 2018. Successful PVC ablations, in which the PVCs were mapped from the right ventricular outflow tract, coronary cusps, commissures, endocardial LV, and the coronary venous system including the dGCV were included. ECG characteristics were compared between patients with successful ablations in the dGCV and non-dGCV sites. Results Of the 120 patients (age 56.8 ± 13.8 years, 45% female) that met the inclusion criteria, the dGCV was the successful ablation site in 18 patients (15%). Multivariate analysis with binary logistic regression showed that a "w" in lead I in combination with an early precordial pattern break and a maximum deflection index (MDI) ≥ 0.5 had sensitivity and specificity for a successful ablation in the dGCV of 94.4% and 96.1%, respectively. Conclusion Combining a "w" wave in lead I with an early precordial pattern break and an MDI ≥ 0.5 is highly sensitive and specific for identifying the dGCV as a successful ablation site for PVCs.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f45e5c9c54216855781f0a2138849b97 https://pubmed.ncbi.nlm.nih.gov/32618396 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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