Document Detail

Development and validation of an ECG algorithm for identifying the optimal ablation site for idiopathic ventricular outflow tract tachycardia.
MedLine Citation:
PMID:  14678101     Owner:  NLM     Status:  MEDLINE    
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 multi-plane 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 ventricular 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.
Sachiko Ito; Hiroshi Tada; Shigeto Naito; Kenji Kurosaki; Marehiko Ueda; Hiroshi Hoshizaki; Isamu Miyamori; Shigeru Oshima; Koichi Taniguchi; Akihiko Nogami
Publication Detail:
Type:  Clinical Trial; Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  14     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-17     Completed Date:  2004-03-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1280-6     Citation Subset:  IM    
Third Department of Internal Medicine, Fukui Medical University, Matsuoka, Fukui, Japan.
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MeSH Terms
Catheter Ablation / methods*
Electrocardiography / methods*
Middle Aged
Prospective Studies
Sensitivity and Specificity
Tachycardia, Ventricular / complications,  diagnosis*,  surgery*
Ventricular Premature Complexes / complications,  diagnosis*,  surgery*
Comment In:
J Cardiovasc Electrophysiol. 2003 Dec;14(12):1287-8   [PMID:  14678102 ]
J Cardiovasc Electrophysiol. 2004 May;15(5):616; author reply 616-7   [PMID:  15149438 ]

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