Document Detail


Development of a Magnetocardiography-based Algorithm for Discrimination between Ventricular Arrhythmias Originating from the Right Ventricular Outflow Tract and the Aortic Sinus Cusp: a Pilot Study.
MedLine Citation:
PMID:  24887136     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Although several reports address characteristic 12-lead ECG findings of outflow tract ventricular arrhythmias (OT-VAs), accuracy of the ECG algorithms to predict OT-VA origin is sometimes limited.
OBJECTIVE: This study aimed to develop a magnetocardiography (MCG)-based algorithm using a novel adaptive spatial filter to differentiate between VAs originating from the aortic sinus cusp (ASC-VA) and those from the right ventricular OT (RVOT-VA).
METHODS: This study comprised 51 patients with OT-VA as the target of catheter ablation. An algorithm was developed by correlating MCG findings with the successful ablation site. The arrhythmias were classified as RVOT-VA or ASC-VA. Three parameters were obtained from 3-D MCG imaging: depth of the origin of OT-VA in the anteroposterior direction, distance between the earliest atrial activation site, i.e., sinus node, and the origin of the OT-VA, and orientation of the arrhythmia propagation at the QRS peak. The distance was indexed to the patient's body surface area (mm/m(2)).
RESULTS: Origins of ASC-VAs were significantly deeper (81±6 vs 68±8 mm/m(2), P<.01) and further from the sinus node (55±9 vs 41±9 mm/m(2), P<.01) than those of RVOT-VAs. ASC-VA propagation had a tendency toward rightward axis. ROC analyses determined that the depth of origin was the most powerful predictor, with sensitivity of 90% and specificity of 73% (P<.01, AUC=.90). Discriminant analysis combining all 3 parameters revealed the accuracy of the localization to be 94%.
CONCLUSION: This MCG-based algorithm appeared to precisely discriminate ASC-VAs from RVOT-VAs. Further investigation is required to validate the clinical value of this technique.
Authors:
Yoko Ito; Keisuke Shiga; Kentaro Yoshida; Kuniomi Ogata; Akihiko Kandori; Takeshi Inaba; Yoko Nakazawa; Yukio Sekiguchi; Hiroshi Tada; Kensuke Sekihara; Kazutaka Aonuma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-30
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-6-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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