Aims: The aim of this study was to use non-invasive electrocardiographic imaging (ECGI) to study the electrophysiological properties of right ventricular outflow tract (RVOT) in patients with frequent premature ventricular contractions (PVCs) from the RVOT and in controls.
Methods: ECGI is a combined application of body surface electrocardiograms and computed tomography or magnetic resonance imaging data. Unipolar electrograms are reconstructed on the epicardial and endocardial surfaces. Activation time (AT) was defined as the time of maximal negative slope of the electrogram (EGM) during QRS, recovery time (RT) as the time of maximal positive slope of the EGM during T wave, Activation recovery interval (ARI) was defined as the difference between RT and AT. ARI dispersion (Δ ARI) and RT dispersion (Δ RT) were calculated as the difference between maximal and minimal ARI and RT respectively. We evaluated those parameters in patients with frequent PVCs from the RVOT, defined as >10.000 per 24 h, and in a control group.
Results: We studied 7 patients with frequent RVOT PVCs and 17 controls. Patients with PVCs from the RVOT had shorter median RT than controls, in the endocardium and in the epicardium, respectively 380 (239-397) vs 414 (372-448) ms, p = 0.047 and 275 (236-301) vs 330 (263-418) ms, p = 0.047. The dispersion of ARI and of RT in the epicardium was higher than in controls, Δ ARI of 145 (68-216) vs 17 (3-48) ms, p = 0.001 and Δ RT of 201 (160-235) vs 115 (65-177), p = 0.019.
Conclusion: In this group of patients we found a shorter median RT in the endocardium and in the epicardium of the RVOT and a higher dispersion of the ARI and RT across the epicardium in patients with PVCs from the RVOT when comparing to controls.
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http://dx.doi.org/10.1016/j.jelectrocard.2019.08.046 | DOI Listing |
Pacing Clin Electrophysiol
December 2024
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Background: Predicting premature ventricular contraction (PVC) origin pre-ablation is a fundamental step, as right ventricular outflow tract (RVOT) PVC often leads to higher success rates.
Objective: To compare nine published ECG criteria to differentiate between RVOT and non-RVOT origins of PVCs and develop a stepwise algorithm using those criteria to better determine PVC origin to predict ablation success.
Methods: Two centers were involved in this study, the derivation group and the validation group.
J Electrocardiol
November 2024
Prof. Marmara University School of Medicine, Department of Cardiology, Istanbul, Turkey.
IEEE J Biomed Health Inform
September 2024
Cardiol J
December 2024
3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.
Background: The three-dimensional electroanatomic mapping (EAM) system allows performing catheter ablation (CA) without fluoroscopy in patients with premature ventricular contractions (PVCs). The right ventricle outflow tract (RVOT) location is favorable for performing zero-fluoroscopy CA. Non-RVOT zero-fluoroscopy CA is a challenging procedure.
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June 2024
Cardiology Department, Health Sciences University, Adana City Education and Research Hospital, Adana, Turkey.
Introduction: Mapping and radiofrequency ablation (RFA) of premature ventricular contractions (PVC) that show diurnal changes during the day, and which are rare during 3-D mapping has become very difficult. The most delayed signal mapping in the right ventricular outflow tract (RVOT) with RV apical pacing might be useful in these situations and we called this method Secret Signal Delayed Mapping (SSDM).
Aim: To compare the classical RFA and SSDM in patients with PVC.
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