Electrocardiographic algorithms to guide a management strategy of idiopathic outflow tract ventricular arrhythmias

Ludwik, Bartosz; Deutsch, Karol; Mazij, Mariusz; Śledź, Janusz; Morka, Aleksandra; Labus, Michał; Chrabąszcz, Michał; Szafran, Bartosz; Śpikowski, Jerzy; Szydłowski, Lesław; Stec, Sebastian

doi:10.20452/pamw.4097

Cited by 2 publications

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“…Mean age was 52 ± 15 years and 55% were women. Most of the patients suffered from PVCs (89%) and had a median pre‐ablation PVC burden of 22%, 11–30 whereas 26% suffered from non‐sustained or sustained VT. Median left ventricular ejection fraction (LVEF) was 60% [IQR 55−65].…”

Section: Resultsmentioning

confidence: 99%

“…For better discrimination, several ECG algorithms have been developed in the past years including V 2 transition ratio, 19 V 2 S/V 3 R index, 20 transition zone index (TZI), 21 or the combination of these. 22,23 To simplify the process of predicting the site of origin of idiopathic VA, Penela et al developed an easy-to-use clinical score to predict LVOT origin, reporting a sensitivity and specificity of 71% and 74%, respectively. 24 The score consists of three clinical parameters (arterial hypertension, male sex and age >50 years), each equally weighted 24 (Table S1).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, PVCs with precordial transition at V 3 may be either originate on the right or left side. For better discrimination, several ECG algorithms have been developed in the past years including V 2 transition ratio, 19 V 2 S/V 3 R index, 20 transition zone index (TZI), 21 or the combination of these 22,23 …”

Section: Introductionmentioning

confidence: 99%

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Validation of a clinical model for predicting left versus right ventricular outflow tract origin of idiopathic ventricular arrhythmias

Bourquin,

Küffer,

Asatryan

et al. 2023

Pacing Clinical Electrophis

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BackgroundPrediction of the chamber of origin in patients with outflow tract ventricular arrhythmias (OTVA) remains challenging. A clinical risk score based on age, sex and presence of hypertension was associated with a left ventricular outflow tract (LVOT) origin. We aimed to validate this clinical score to predict an LVOT origin in patients with OTVA.MethodsIn a two‐center observational cohort study, unselected patients undergoing catheter ablation (CA) for OTVA were enrolled. All procedures were performed using an electroanatomical mapping system. Successful ablation was defined as a ≥80% reduction of the initial overall PVC burden after 3 months of follow‐up. Patients with unsuccessful ablation were excluded from this analysis.ResultsWe included 187 consecutive patients with successful CA of idiopathic OTVA. Mean age was 52 ± 15 years, 102 patients (55%) were female, and 74 (40%) suffered from hypertension. A LVOT origin was found in 64 patients (34%). A score incorporating age, sex and presence of hypertension reached 73% sensitivity and 67% specificity for a low (0–1) and high (2–3) score, to predict an LVOT origin. The combination of one ECG algorithm (V2S/V3R‐index) with the clinical score resulted in a sensitivity and specificity of 81% and 70% for PVCs with R/S transition at V3.ConclusionThe published clinical score yielded a lower sensitivity and specificity in our cohort. However, for PVCs with R/S transition at V3, the combination with an existing ECG algorithm can improve the predictability of LVOT origin.

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Section: Resultsmentioning

confidence: 99%