Document Detail

Effect of Limb Lead Electrodes Location on ECG and Localization of Idiopathic Outflow Tract Tachycardia: A Prospective Study.
MedLine Citation:
PMID:  21332862     Owner:  NLM     Status:  Publisher    
Role of ECG in Localization of OT-VT. Background: Different kinds of the surface ECG limb electrode positions may affect the limb lead vector and therefore the accuracy of the 12-lead ECG in localization of outflow tract ventricular tachycardia (OTVT). This study was intended to evaluate and compare the accuracy of the standard and the modified 12-lead ECG for localization of OTVT using the current published criteria. Methods and Results: Twenty consecutive patients (10 men, mean age, 51.6 ± 13.4 years) with OT-VT were included. A standard ECG with the distal placement of the limb lead electrodes and a modified ECG with the limb electrodes placed on the torso were recorded during the OT-VT and were used for localization by 2 electrophysiologists who were blinded to the successful ablation site to compare the accuracy of the 2 ECGs. The R wave amplitude during OT-VT in lead I of the standard 12-lead ECG was significantly higher compared to the modified surface ECG (0.225 ± 0.145 mV vs 0.139 ± 0.111 mV, P = 0.032). The S wave in aVR during OT-VT was significantly more negative compared to the modified surface ECG (-0.682 ± 0.182 mV vs -0.527 ± 0.228 mV, P = 0.017). The rate of accurate localization of the successful ablation sites in the anterior versus posterior outflow tract by the 2 observers using standard ECG (70% and 80%) were higher compared to modified ECG (50% and 60%, P = 0.042). Conclusion: The R wave amplitude in lead I and the depth of the S wave amplitude in lead aVR of the standard surface ECG during OT-VT is significantly larger compared to the modified surface ECG. As the QRS morphology of the OT-VT is usually the first clue to the possible site of successful ablation, the standard 12-lead ECG should be used for more accurate localization of the origin of the OT-VT. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Arash Arya; Yan Huo; Fredrick Frogner; Ulrike Wetzel; Philipp Sommer; Thomas Gaspar; Sergio Richter; Christopher Piorkowski; Gerhard Hindricks
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-21
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
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