Importance of great cardiac vein signal in the differentiation of premature ventricular contraction origins in right and left ventricular outflow tracts

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
A. Fazelifar, Behzad Amanpour, M. Heidarali, A. Arani
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引用次数: 0

Abstract

Background and Aim: “Idiopathic” ventricular arrhythmias most often arise from the right ventricular outflow tract (RVOT), although arrhythmias from the left ventricular outflow tract (LVOT) have also been observed. The aim of the study was to investigate the importance of signal of great cardiac vein (GCV) to distinguish premature ventricular contraction (PVC) originated from LVOT and PVC originated from RVOT. Materials and Methods: A coronary sinus catheter was placed in the GCV under fluoroscopy to measure the distance of GCV signal to the onset of QRS on surface electrocardiogram (ECG). Catheter ablation was performed utilizing radiofrequency energy in 31 patients. A 12-lead ECG was recorded during PVC. Successful ablation was defined as the complete disappearance of target PVC with no recurrence during the follow-up. Results: Thirty-one consecutive patients (16 male [51.6%]) were enrolled. Overall, 67.7% of the cases had PVC originated from the LVOT and 32.3% from the RVOT. Out of 48.4% of the females, 33.3% had PVC originated from the RVOT and 66.7% from the LVOT (P = 1). The mean ejection fraction regarding PVC originated from the LVOT and RVOT was 47.50 ± 8.95 and 45.50 ± 8.51, respectively (P = 0.7). The distance of GCV signal to the onset of QRS on surface ECG for LVOT- and RVOT-originated PVC was 15.38 ± 25.28 and −29.70 ± 25.66, respectively (P < 0.01). Conclusions: The differentiation between PVC originated from LVOT and RVOT is not entirely utilized through ECG criteria, thus the origin of PVC arising from RVOT/LVOT can be localized using the GCV signals.
大心静脉信号在区分左心室流出道和右心室早搏起源中的重要性
背景和目的:“特发性”室性心律失常最常见于右心室流出道(RVOT),尽管也观察到来自左心室流出道的心律失常。本研究的目的是探讨心大静脉信号(GCV)在区分起源于LVOT的室性早搏(PVC)和起源于RVOT的PVC中的重要性。材料和方法:在荧光镜下将冠状窦导管置于GCV中,在表面心电图(ECG)上测量GCV信号到QRS发作的距离。利用射频能量对31名患者进行导管消融术。PVC过程中记录了12导联心电图。成功的消融被定义为在随访期间目标PVC完全消失且无复发。结果:31名连续患者(16名男性[51.6%])入选。总体而言,67.7%的病例的PVC来源于左心室流出道,32.3%来源于右心室流出道。48.4%的女性中,33.3%的PVC来源于右心室流出道,66.7%来源于左心室流出道(P=1)。起源于LVOT和RVOT的PVC的平均射血分数分别为47.50±8.95和45.50±8.51(P=0.07),结论:LVOT引起的PVC与RVOT之间的鉴别不能完全通过心电图来判断,因此可以通过GCV信号来定位RVOT/LVOT引起的PVC的起源。
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来源期刊
Research in Cardiovascular Medicine
Research in Cardiovascular Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
自引率
0.00%
发文量
13
审稿时长
17 weeks
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