Document Detail


Electrocardiographic predictors of failure and recurrence in patients with idiopathic right ventricular outflow tract tachycardia and ectopy who underwent radiofrequency catheter ablation.
MedLine Citation:
PMID:  14661169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study reports new electrocardiographic (ECG) predictors of radiofrequency catheter ablation failure and recurrence in idiopathic right ventricular outflow tract (RVOT) ventricular tachycardia (VT) or ectopy based on 91 consecutive patients. Procedural success and failure rates were 85% (77/91) and 15% (14/91), respectively. Twenty three percent (18/77) had recurrence during the follow-up period of 1 to 120 months (mean 56 +/- 31 months). Baseline RVOT VT/ectopy on 12-lead ECG taken prior to ablation from 91 patients were retrospectively analyzed. Ablation performed with RVOT ectopy (isolated ectopies, bigeminy, trigeminy, or couplets) as template arrhythmia was more likely to fail (30% vs. 8%, P =.02) as opposed to RVOT VT (sustained or nonsustained). VT/ectopy-QRS morphology variation was more observed in failed ablations (36% vs. 7%, P =.001). Significantly wider mean VT/ectopy QRS in leads I, II, AVR, V2, V3, V5, and V6 were noted in failed ablation group. Mean R wave amplitude reached statistical significance only in lead II (22.0 +/- 5.1 mV for failed vs. 17.8 +/- 5.2 mV for successful outcomes; P =.009). QRS morphologic variation (47% vs. 16%; P =.009) was the only statistically significant ECG to be more common in patients with arrhythmia recurrence. In conclusion, ablation with ectopy over VT as template arrhythmia, presence of QRS morphologic variation, wider mean QRS width, and taller mean R-wave amplitude in lead II were identified ECG predictors of failed RVOT VT/Ectopy ablation. The only ECG predictor of recurrence was the presence of RVOT VT or ectopy QRS morphologic variation.
Authors:
Marivic Vestal; Ming-Shien Wen; San-Jou Yeh; Chun-Chieh Wang; Fun-Chung Lin; Delon Wu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  36     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-12-08     Completed Date:  2005-06-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-32     Citation Subset:  IM    
Affiliation:
Department of Medicine, Second Section of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Bundle-Branch Block / diagnosis,  etiology*,  surgery*
Catheter Ablation*
Child
Electrocardiography*
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Humans
Male
Middle Aged
Postoperative Complications / diagnosis,  etiology
Predictive Value of Tests
Recurrence
Retrospective Studies
Tachycardia, Ventricular / diagnosis,  etiology*,  surgery*
Time
Treatment Failure
Ventricular Outflow Obstruction / diagnosis,  etiology*,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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