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Electrocardiographic Determinants of the Polymorphic QRS Morphology in Idiopathic Right Ventricular Outflow Tract Tachycardia.
MedLine Citation:
PMID:  22136173     Owner:  NLM     Status:  Publisher    
Coupling Intervals and Polymorphic QRS Morphologies. Introduction: Premature ventricular contractions (PVCs) arising from the right ventricular outflow tract (RVOT) can trigger polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF) in patients with no structural heart disease. We aimed to clarify the ECG determinants of the polymorphic QRS morphology in idiopathic RVOT PVT/VF. Methods and Results: The ECG parameters were compared between 18 patients with idiopathic PVT/VF (PVT-group) and 21 with monomorphic VT arising from the RVOT (MVT-group). The coupling interval (CI) of the first VT beat was comparable between the 2 groups. However, the prematurity index (PI) of the first VT beat was smaller in the PVT-group than in the MVT-group (P  <  0.001). Furthermore, the QT index, defined as the ratio of the CI to the QT interval of the preceding sinus complex, was also smaller for the PVT/VF in the PVT-group than that for the VT in the MVT-group (P  <  0.01). In the PVT-group, the CI of the first VT beat was comparable between that of VT and isolated PVCs, but the PI of the first VT beat was shorter for VT than isolated PVCs (P  <  0.05). The PI was the only independent determinant of the polymorphic QRS morphology (odd ratio = 2.198; 95% confidence interval = 1.321-3.659; P = 0.002). Conclusion: The smaller PIs of the first VT beat may result in a polymorphic QRS morphology. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Miyako Igarashi; Hiroshi Tada; Kenji Kurosaki; Hiro Yamasaki; Daiki Akiyama; Yukio Sekiguchi; Kenji Kuroki; Takeshi Machino; Nobuyuki Murakoshi; Yoshio Nakata; Keisuke Kuga; Akihiko Nogami; Kazutaka Aonuma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-2
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-5     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.
Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan Division of Cardiology, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan Tsukuba Critical Path Research and Education Integrated Leading Center (CREIL), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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