AI Article Synopsis
- This study investigated the ECG features of ventricular arrhythmias (VAs) originating near the mitral annulus (MA) in 283 patients who underwent radiofrequency catheter ablation.
- By analyzing ECG data, the research established specific markers (like intrinsicoid deflection time and maximum deflection index) that could predict whether the VAs were coming from the epicardial or endocardial areas.
- The findings showed strong predictive values for identifying the origin of VAs based on ECG characteristics, which can aid in creating targeted ablation strategies.
Article Abstract
Background: This study aimed to explore the electrocardiographic (ECG) characteristics of ventricular arrhythmias (VAs) arising from epicardial and endocardial areas adjacent to the mitral annulus (MA).
Methods: This study involved 283 patients with MA-VAs who received radiofrequency catheter ablation at the center. The ECG characteristics of these patients were analyzed retrospectively.
Results: The origin of MA-VAs was judged based on the ECG variables. Among all MA-VAs, intrinsicoid deflection time (IDT) > 77 ms or maximum deflection index (MDI) > 0.505 predicted the VAs arising from the epicardium (sensitivity of 70.20% and 73.51%, specificity of 94.70% and 82.58%, positive predictive value (PPV) of 93.81% and 82.84%, and negative predictive value (NPV) of 73.53% and 73.15%). Among all epicardial MA-VAs, the RV1/RV2 ratio > 0.87 predicted the VAs originating from the epicardial anteroseptal wall adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 62.86%, 98.06%, 91.67%, and 88.60%, respectively. Among all endocardial MA-VAs, Q(q)R(r) morphology in lead V1 predicted the VAs arising from the endocardial septal wall adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 92.98%, 100%, 100%, and 94.94%, respectively. Among all endocardial septal MA-VAs, a predominant positive wave in lead II and a predominant negative wave in lead III predicted the VAs arising from the endocardial midseptal portion adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 86.04%, 100%, 100%, and 70.00%, respectively.
Conclusion: the ECG characteristics of VAs from the different sites adjacent to the MA can enable judging the arrhythmia's origin and designing the ablation plan accordingly.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455119 | PMC |
| http://dx.doi.org/10.3390/jcdd10080334 | DOI Listing |
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