Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia
Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia
复制标题
DOI：
10.1046/j.1540-8167.2003.03211.x
复制
发表时间：
2003-12-01
影响因子：
2.7
通讯作者：
Nogami, A
中科院分区：
文献类型：
--
作者：
Ito, S;Tada, H;Nogami, A
ECG算法和流出道心动过速。简介：特发性室性流出道心动过速或室性早搏（OT-VT）可起源于流出道的几个不同部位，包括左心室（LV）内膜和心外膜。本研究的目的是（1）开发一种心电图算法来预测的起源OT-VT和（2）前瞻性测试的准确性的algorithm.Methods和Results：一个算法开发相关的12导联心电图结果与导管消融部位在80例OT-VT。分析心律失常时QRS波群的心电图特征。通过多平面荧光镜检查验证导管部位。流出道分为6个亚部：右心室（RV）间隔、RV游离壁、靠近希氏束区域的RV、LV内膜、左Valsalva窦（LSV）和远离LSV的LV心外膜。起源于远离LSV的LV心外膜的OT-VT定义为在LSV记录到最早心室激动且LSV射频消融失败的OT-VT。该算法随后在88例患者中进行了前瞻性测试。总体敏感性为88%，特异性为95%。阳性和阴性预测值分别为88%和96%，respectively.Conclusion：我们描述了一种新的ECG算法，具有高灵敏度和特异性，以确定特发性室性流出道心动过速或室性早搏的最佳消融部位。
ECG Algorithm and Outflow Tract Tachycardia. Introduction: Idiopathic ventricular outflow tract tachycardia or premature ventricular contractions (OT-VTs) can originate from several different sites in the outflow tract, including the left ventricular (LV) endocardium and epicardium. The aims of this study were (1) to develop an ECG algorithm to predict the origin of OT-VT and (2) to test prospectively the accuracy of the algorithm.Methods and Results: An algorithm was developed by correlating the 12-lead ECG findings with the catheter ablation site in 80 patients with OT-VT. The ECG characteristics of the QRS complex during the arrhythmia were analyzed. The catheter sites were verified by multiplane fluoroscopy. The outflow tract was classified into six subdivisions: right ventricular (RV) septum, RV free wall, RV near the His-bundle region, LV endocardium, left sinus of Valsalva (LSV), and LV epicardium remote from the LSV. An OT-VT originating from the LV epicardium remote from the LSV was defined as an OT-VT in which the earliest ventricuIar activation was recorded at the LSV and radiofrequency ablation from the LSV failed. This algorithm subsequently was tested prospectively in 88 patients. Overall sensitivity was 88% and specificity was 95%. The positive and negative predictive values were 88% and 96%, respectively.Conclusion: We describe a new ECG algorithm having a high sensitivity and specificity to identify the optimal ablation site for idiopathic ventricular outflow tachycardia or premature ventricular contractions.