Document Detail

Novel ECG predictor of difficult cases of outflow tract ventricular tachycardia: peak deflection index on an inferior lead.
MedLine Citation:
PMID:  20009358     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An ECG predictor of ablation success has not been determined for difficult cases of outflow tract ventricular tachycardia/ventricular premature contractions (OT-VT/VPC). METHODS AND RESULTS: ECG analysis and radiofrequency catheter ablation (RFCA) were performed in 70 patients with OT-VT/VPC. The peak deflection index (PDI) was determined in the inferior lead presenting the tallest R wave by dividing the time from QRS onset to peak QRS deflection by total QRS duration. In 10 (14%) of the 70 patients, RFCA performed at a septal or epicardial site was unsuccessful (group 1), but was successful in the remaining 60 patients (group 2). Neither activation time (35+/-15 ms vs 40+/-12 ms, P=0.3) nor QRS duration (141+/-19 ms vs 137+/-19 ms, P=0.6) were significantly different between groups 1 and 2. However, PDI was significantly higher in group 1 than in group 2 (0.62+/-0.06 vs 0.55+/-0.06, P=0.002). A PDI >0.6 identified unsuccessful OT-VT/VPC with 80% sensitivity and 90% specificity, and may indicate that the origin of the OT-VT/VPC is deep within the ventricular septum or at an epicardial site. CONCLUSIONS: A PDI >0.6 is more likely to be associated with a higher rate of RFCA failure.
Hitoshi Hachiya; Kenzo Hirao; Takeshi Sasaki; Koji Higuchi; Tatsuya Hayashi; Yasuaki Tanaka; Mihoko Kawabata; Mitsuaki Isobe
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Publication Detail:
Type:  Journal Article     Date:  2009-12-14
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-25     Completed Date:  2010-03-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  256-61     Citation Subset:  IM    
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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MeSH Terms
Catheter Ablation
Electrocardiogram Pattern*
Heart Conduction System / physiopathology*,  surgery
Middle Aged
Predictive Value of Tests
Tachycardia, Ventricular / diagnosis*,  physiopathology,  surgery
Time Factors
Treatment Failure
Ventricular Premature Complexes / diagnosis*,  physiopathology,  surgery

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