Interventricular septum angle obtained from cardiac computed tomography for origin differentiation of outflow tract ventricular arrhythmia between left and right.

Pacing and clinical electrophysiology : PACE Pub Date : 2022-11-01 Epub Date: 2022-09-23 DOI:10.1111/pace.14593
Xiaomei Zhu, Shumin Chen, Kefan Ma, Zenghong Chen, Chun Chen, Zhixin Jiang
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Abstract

Aims: Our objective was to explore whether the accuracy of the transitional zone index (TZI) for outflow tract ventricular arrhythmias (OT-VAs) origin is affected by cardiac rotation and the additive value of interventricular septum angle (IVSa) obtained from coronary computed tomography angiography (CCTA).

Methods: Standard 12-lead ECGs of OT-VAs with inferior axis in consecutive patients undergoing both CCTA examination and successful ablation were retrospectively analyzed. The IVSa was defined as an angle between the long axis of IVS and sagittal axis of the body from CCTA.

Results: 64 patients (31 men; mean age 54.2 ± 11.6 years) were enrolled. The OT-VAs exhibited right ventricular outflow tract origin in 46 (71.9%) patients and 36 (78.3%) were diagnosed correctly by TZI. The left ventricular outflow tract origin OT-VAs was observed in 18 (28.1%) patients and 16 (88.9%) were diagnosed correctly by TZI. The patients were then divided into TZI correct group (n = 52) and TZI incorrect group (n = 12). In the TZI incorrect group, 11/12 (91.7%) cases were R/S transition in lead V3 with the TZ score during premature ventricular contractions [2.8(2.5-3.4)], and the TZI between -1.5 and 0. The IVSa was significantly larger in the TZI incorrect group than correct group (52.0 ± 6.9° vs. 39.0 ± 6.1°; p < .0001). The IVSa ≥46° predicted TZI incorrect with 92% sensitivity, 94% specificity, and 94% accuracy.

Conclusion: The IVSa is a novel cardiac rotation index that reliably improves TZI to differentiate the OT-VAs origin, especially for the OT-VAs with lead V3 R/S transition.

心脏计算机断层对左、右流出道室间隔角的起源鉴别。
目的:我们的目的是探讨心脏旋转和冠状动脉ct血管造影(CCTA)获得的室间隔角(IVSa)的叠加值是否影响流出道室性心律失常(OT-VAs)起源的过渡区指数(TZI)的准确性。方法:回顾性分析连续行CCTA检查并消融成功患者的下轴OT-VAs标准12导联心电图。IVSa定义为CCTA上IVS长轴与身体矢状轴之间的夹角。结果:64例患者(男性31例;平均年龄(54.2±11.6岁)。46例(71.9%)患者的OT-VAs显示右室流出道起源,36例(78.3%)患者的TZI诊断正确。18例(28.1%)患者观察到左心室流出道起源的OT-VAs, 16例(88.9%)患者被TZI正确诊断。将患者分为TZI正确组(n = 52)和TZI错误组(n = 12)。在TZI不正确组中,11/12例(91.7%)患者在室性早搏时TZ评分为R/S转换[2.8(2.5 ~ 3.4)],TZI在-1.5 ~ 0之间。TZI错误组IVSa明显大于正确组(52.0±6.9°vs 39.0±6.1°);p & lt;。)。IVSa≥46°预测TZI不正确的灵敏度为92%,特异性为94%,准确度为94%。结论:IVSa是一种新的心脏旋转指标,可可靠地改善TZI,以区分OT-VAs的起源,特别是对于导联V3 R/S过渡的OT-VAs。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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