Document Detail

An Electrocardiographic Scoring System for Distinguishing Right Ventricular Outflow Tract Arrhythmias in Patientswith Arrhythmogenic Right Ventricular Cardiomyopathy from Idiopathic Ventricular Tachycardia.
MedLine Citation:
PMID:  23246596     Owner:  NLM     Status:  Publisher    
BACKGROUND: Ventricular arrhythmias in ARVD/C and idiopathicVT patients can share a left bundle branch block/inferior axis morphology. We previously reported ECG characteristics during outflow tract ventricular arrhythmias that helped distinguish VT related to ARVD/C from idiopathicVT. OBJECTIVE: The purpose of this study was to prospectively validate these criteria. METHODS: We created a risk score using a derivation cohort. Two experienced electrophysiologists blinded to the diagnosis prospectively scored patients with VT/PVCs with LBBB/inferior axis pattern in a validation cohort of 37 ARVD/C tracings and 49idiopathicVT tracings. All ARVD/C patients had their diagnosis confirmed based on the revised Task Force criteria. IdiopathicVT patients were selected based on structurally normal hearts with documented RV outflow tract VT successfully treated with ablation. The scoring system provides 3 points for sinus rhythm anterior T wave inversions in leads V1 through V3, and during ventricular arrhythmia: 2 points for QRS duration in lead I ≥120msec, 2 points for QRS notching, and 1 point for precordial transition at lead V5 or later. RESULTS: A score of 5 or greater was able to correctly distinguish ARVD/C from idiopathicVT 93% of the time, with a sensitivity of 84%, specificity of 100%, positive predictive value 100%, and negative predictive value 91%. CONCLUSIONS: We describe a simple scoring algorithm that uses 12 lead ECG characteristics to effectively distinguish right ventricular outflow tract arrhythmias originating from ARVD/C versus idiopathicVT patients.
Kurt S Hoffmayer; Prashant D Bhave; Gregory M Marcus; Cynthia A James; Crystal Tichnell; Nagesh Chopra; Laura Wood; Andrew D Krahn; Sanjay Dixit; William Stevenson; Hugh Calkins; Nitish Badhwar; Edward P Gerstenfeld; Melvin M Scheinman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-11
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-18     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 © 2012. Published by Elsevier Inc.
The University of California, San Francisco, California.
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