Document Detail

Mapping Data Predictors of a Left Ventricular Outflow Tract Origin of Idiopathic Ventricular Tachycardia with V3 Transition and Septal Earliest Activation.
MedLine Citation:
PMID:  22589285     Owner:  NLM     Status:  Publisher    
BACKGROUND: -The proximity of the outflow tracts (OTs) frequently results in an overlap in surface electrocardiographic (ECG) features of ventricular arrhythmias (VAs) originating from this anatomic region, particularly when the transition occurs in lead V3. In addition, no reliable criteria to discriminate between a right ventricular outflow tract (RVOT) and a left ventricular outflow tract (LVOT) site of origin (SOO) are derived from intracardiac mapping. METHODS AND RESULTS: -A series of 15 patients submitted for ablation because of OT VAs having a V3 transition and septal earliest activation on the RVOT was included in the study. ECG and mapping data were collected to analyze accuracy in predicting the RVOT vs LVOT SOO of the VA. The 10 ms isochronal map area in the RVOT was smaller in the RVOT SOO group (1.2 [0.4-2.1] vs 3.4 [2.4-3.9] cm(2) respectively, P = 0.004) and had a shorter perpendicular diameter (13 [7-17] vs 28 [20-29] mm, P = 0.001) and a higher longitudinal/perpendicular axis ratio (1.04 [0.95-1.11] vs 0.49 [0.44-0.57], P = 0.001). A 10 ms isochronal map area >2.3 cm(2) predicted a LVOT origin with 85.7% sensitivity and 87.5% specificity, while a longitudinal/perpendicular axis ratio <0.8 predicted a LVOT origin with 100% sensitivity and 100% specificity. ECG-derived parameters showed lower values of sensitivity and specificity. The distal coronary sinus (CS) activation mapping did not permit distinction between RVOT and LVOT SOO. CONCLUSIONS: -The 10 ms isochronal map area and the longitudinal/perpendicular axis ratio accurately predict the RVOT versus LVOT SOO in patients with OT VAs, a V3 transition and septal earliest activation.
Csaba Herczku; Antonio Berruezo; David Andreu; Juan Fernández-Armenta; Lluis Mont; Roger Borràs; Elena Arbelo; Jose M Tolosana; Emilce Trucco; José Ríos; Josep Brugada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-15
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Thorax Inst, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
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