The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias
The aim of this study was to develop a new electrocardiographic criterion for differentiating the origin of outflow tract ventricular arrhythmias (OT-VAs) with precordial transition in lead V . A total of 147 consecutive patients with OT-VAs displaying precordial transition in lead V who underwent s...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2019-10, Vol.56 (1), p.37 |
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| container_title | Journal of interventional cardiac electrophysiology |
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| creator | Di, Chengye Wan, Zheng Tse, Gary Letsas, Konstantinos P Liu, Tong Efremidis, Michael Li, Jianming Lin, Wenhua |
| description | The aim of this study was to develop a new electrocardiographic criterion for differentiating the origin of outflow tract ventricular arrhythmias (OT-VAs) with precordial transition in lead V
.
A total of 147 consecutive patients with OT-VAs displaying precordial transition in lead V
who underwent successful catheter ablation in the right ventricular outflow tract (RVOT) (n = 118) or left ventricular outflow tract (LVOT) (n = 29) were included in this study. The V
-V
transition index was defined as the sum of S-wave amplitude in lead V
and V
during premature ventricular contractions (PVCs) divided by the S-wave amplitude during sinus rhythm (SR), respectively, minus the sum of R-wave amplitude in lead V
, V
, and V
during PVCs divided by the R-wave amplitude during SR, respectively, i.e., [(S
/S
)V
+ (S
/S
)V
] - [(R
/R
) V
+ (R
/R
)V
+ (R
/R
)V
].
The V
-V
transition index was significantly higher for RVOT origins than for LVOT origins (1.25 ± 2.48 vs. - 3.94 ± 3.11; P - 1.60 predicted a RVOT origin with a 93% sensitivity and 86% specificity. With respect to AUC and accuracy, the V
-V
transition index was superior to any previously proposed ECG indices for differentiating left from right OT-VAs. In 37 prospective cases, the new index was able to predict the site of a RVOT origin with 95% accuracy (35 of 37 cases).
The V
-V
transition index is a useful novel ECG criterion for distinguishing left from right OT-VAs with precordial transition in lead V
. |
| doi_str_mv | 10.1007/s10840-019-00612-0 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed</sourceid><recordid>TN_cdi_pubmed_primary_31478158</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>31478158</sourcerecordid><originalsourceid>FETCH-LOGICAL-p108t-4dfcc004628ddc19f5f18f60ba4baf52db817f9077bdf23ac5ca576c5e34c1d23</originalsourceid><addsrcrecordid>eNpVkE1OwzAUhC0kREvhAizQu4DhOYnzs0QVUKRKbEq3leOfxiiJoxe30MNwV1oBC1az-EYzmmHsRuCdQCzuR4FlhhxFxRFzkXA8Y1Mhi4SXspITdjmO74hYYZJfsEkqsqIUspyyr1VjYQ0C-BpSiKT60UcfevC9sZ-gRlDQh71twbZWRwpakfFhS2povAZNPlo6-V0gMN45S7aPXkXfb6G1LoKj0AH5bRNhf0Tk9a5VBGEXXRs-TpX6P1FEzSE2nVfjFTt3qh3t9a_O2NvT42q-4MvX55f5w5IPx9mRZ8ZpjZjlSWmMFpWTTpQux1pltXIyMXUpCldhUdTGJanSUitZ5FraNNPCJOmM3f7kDru6s2YzkO8UHTZ_P6Xf6rxtxw</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Di, Chengye ; Wan, Zheng ; Tse, Gary ; Letsas, Konstantinos P ; Liu, Tong ; Efremidis, Michael ; Li, Jianming ; Lin, Wenhua</creator><creatorcontrib>Di, Chengye ; Wan, Zheng ; Tse, Gary ; Letsas, Konstantinos P ; Liu, Tong ; Efremidis, Michael ; Li, Jianming ; Lin, Wenhua</creatorcontrib><description>The aim of this study was to develop a new electrocardiographic criterion for differentiating the origin of outflow tract ventricular arrhythmias (OT-VAs) with precordial transition in lead V
.
A total of 147 consecutive patients with OT-VAs displaying precordial transition in lead V
who underwent successful catheter ablation in the right ventricular outflow tract (RVOT) (n = 118) or left ventricular outflow tract (LVOT) (n = 29) were included in this study. The V
-V
transition index was defined as the sum of S-wave amplitude in lead V
and V
during premature ventricular contractions (PVCs) divided by the S-wave amplitude during sinus rhythm (SR), respectively, minus the sum of R-wave amplitude in lead V
, V
, and V
during PVCs divided by the R-wave amplitude during SR, respectively, i.e., [(S
/S
)V
+ (S
/S
)V
] - [(R
/R
) V
+ (R
/R
)V
+ (R
/R
)V
].
The V
-V
transition index was significantly higher for RVOT origins than for LVOT origins (1.25 ± 2.48 vs. - 3.94 ± 3.11; P < 0.001). Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.931 for the V
-V
transition index, and a cutoff value of > - 1.60 predicted a RVOT origin with a 93% sensitivity and 86% specificity. With respect to AUC and accuracy, the V
-V
transition index was superior to any previously proposed ECG indices for differentiating left from right OT-VAs. In 37 prospective cases, the new index was able to predict the site of a RVOT origin with 95% accuracy (35 of 37 cases).
The V
-V
transition index is a useful novel ECG criterion for distinguishing left from right OT-VAs with precordial transition in lead V
.</description><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-019-00612-0</identifier><identifier>PMID: 31478158</identifier><language>eng</language><publisher>Netherlands</publisher><subject>Adolescent ; Adult ; Aged ; Catheter Ablation ; Diagnosis, Differential ; Electrocardiography - methods ; Epicardial Mapping ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular - diagnosis ; Tachycardia, Ventricular - physiopathology ; Tachycardia, Ventricular - surgery ; Ventricular Outflow Obstruction - diagnosis ; Ventricular Outflow Obstruction - physiopathology ; Ventricular Outflow Obstruction - surgery ; Ventricular Premature Complexes - diagnosis ; Ventricular Premature Complexes - physiopathology ; Ventricular Premature Complexes - surgery</subject><ispartof>Journal of interventional cardiac electrophysiology, 2019-10, Vol.56 (1), p.37</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-0482-0738 ; 0000-0001-8924-8261 ; 0000-0002-7777-574X ; 0000-0001-5510-1253</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31478158$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di, Chengye</creatorcontrib><creatorcontrib>Wan, Zheng</creatorcontrib><creatorcontrib>Tse, Gary</creatorcontrib><creatorcontrib>Letsas, Konstantinos P</creatorcontrib><creatorcontrib>Liu, Tong</creatorcontrib><creatorcontrib>Efremidis, Michael</creatorcontrib><creatorcontrib>Li, Jianming</creatorcontrib><creatorcontrib>Lin, Wenhua</creatorcontrib><title>The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><description>The aim of this study was to develop a new electrocardiographic criterion for differentiating the origin of outflow tract ventricular arrhythmias (OT-VAs) with precordial transition in lead V
.
A total of 147 consecutive patients with OT-VAs displaying precordial transition in lead V
who underwent successful catheter ablation in the right ventricular outflow tract (RVOT) (n = 118) or left ventricular outflow tract (LVOT) (n = 29) were included in this study. The V
-V
transition index was defined as the sum of S-wave amplitude in lead V
and V
during premature ventricular contractions (PVCs) divided by the S-wave amplitude during sinus rhythm (SR), respectively, minus the sum of R-wave amplitude in lead V
, V
, and V
during PVCs divided by the R-wave amplitude during SR, respectively, i.e., [(S
/S
)V
+ (S
/S
)V
] - [(R
/R
) V
+ (R
/R
)V
+ (R
/R
)V
].
The V
-V
transition index was significantly higher for RVOT origins than for LVOT origins (1.25 ± 2.48 vs. - 3.94 ± 3.11; P < 0.001). Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.931 for the V
-V
transition index, and a cutoff value of > - 1.60 predicted a RVOT origin with a 93% sensitivity and 86% specificity. With respect to AUC and accuracy, the V
-V
transition index was superior to any previously proposed ECG indices for differentiating left from right OT-VAs. In 37 prospective cases, the new index was able to predict the site of a RVOT origin with 95% accuracy (35 of 37 cases).
The V
-V
transition index is a useful novel ECG criterion for distinguishing left from right OT-VAs with precordial transition in lead V
.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Catheter Ablation</subject><subject>Diagnosis, Differential</subject><subject>Electrocardiography - methods</subject><subject>Epicardial Mapping</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Tachycardia, Ventricular - diagnosis</subject><subject>Tachycardia, Ventricular - physiopathology</subject><subject>Tachycardia, Ventricular - surgery</subject><subject>Ventricular Outflow Obstruction - diagnosis</subject><subject>Ventricular Outflow Obstruction - physiopathology</subject><subject>Ventricular Outflow Obstruction - surgery</subject><subject>Ventricular Premature Complexes - diagnosis</subject><subject>Ventricular Premature Complexes - physiopathology</subject><subject>Ventricular Premature Complexes - surgery</subject><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1OwzAUhC0kREvhAizQu4DhOYnzs0QVUKRKbEq3leOfxiiJoxe30MNwV1oBC1az-EYzmmHsRuCdQCzuR4FlhhxFxRFzkXA8Y1Mhi4SXspITdjmO74hYYZJfsEkqsqIUspyyr1VjYQ0C-BpSiKT60UcfevC9sZ-gRlDQh71twbZWRwpakfFhS2povAZNPlo6-V0gMN45S7aPXkXfb6G1LoKj0AH5bRNhf0Tk9a5VBGEXXRs-TpX6P1FEzSE2nVfjFTt3qh3t9a_O2NvT42q-4MvX55f5w5IPx9mRZ8ZpjZjlSWmMFpWTTpQux1pltXIyMXUpCldhUdTGJanSUitZ5FraNNPCJOmM3f7kDru6s2YzkO8UHTZ_P6Xf6rxtxw</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Di, Chengye</creator><creator>Wan, Zheng</creator><creator>Tse, Gary</creator><creator>Letsas, Konstantinos P</creator><creator>Liu, Tong</creator><creator>Efremidis, Michael</creator><creator>Li, Jianming</creator><creator>Lin, Wenhua</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><orcidid>https://orcid.org/0000-0003-0482-0738</orcidid><orcidid>https://orcid.org/0000-0001-8924-8261</orcidid><orcidid>https://orcid.org/0000-0002-7777-574X</orcidid><orcidid>https://orcid.org/0000-0001-5510-1253</orcidid></search><sort><creationdate>201910</creationdate><title>The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias</title><author>Di, Chengye ; Wan, Zheng ; Tse, Gary ; Letsas, Konstantinos P ; Liu, Tong ; Efremidis, Michael ; Li, Jianming ; Lin, Wenhua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p108t-4dfcc004628ddc19f5f18f60ba4baf52db817f9077bdf23ac5ca576c5e34c1d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Catheter Ablation</topic><topic>Diagnosis, Differential</topic><topic>Electrocardiography - methods</topic><topic>Epicardial Mapping</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Tachycardia, Ventricular - diagnosis</topic><topic>Tachycardia, Ventricular - physiopathology</topic><topic>Tachycardia, Ventricular - surgery</topic><topic>Ventricular Outflow Obstruction - diagnosis</topic><topic>Ventricular Outflow Obstruction - physiopathology</topic><topic>Ventricular Outflow Obstruction - surgery</topic><topic>Ventricular Premature Complexes - diagnosis</topic><topic>Ventricular Premature Complexes - physiopathology</topic><topic>Ventricular Premature Complexes - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di, Chengye</creatorcontrib><creatorcontrib>Wan, Zheng</creatorcontrib><creatorcontrib>Tse, Gary</creatorcontrib><creatorcontrib>Letsas, Konstantinos P</creatorcontrib><creatorcontrib>Liu, Tong</creatorcontrib><creatorcontrib>Efremidis, Michael</creatorcontrib><creatorcontrib>Li, Jianming</creatorcontrib><creatorcontrib>Lin, Wenhua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di, Chengye</au><au>Wan, Zheng</au><au>Tse, Gary</au><au>Letsas, Konstantinos P</au><au>Liu, Tong</au><au>Efremidis, Michael</au><au>Li, Jianming</au><au>Lin, Wenhua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2019-10</date><risdate>2019</risdate><volume>56</volume><issue>1</issue><spage>37</spage><pages>37-</pages><eissn>1572-8595</eissn><abstract>The aim of this study was to develop a new electrocardiographic criterion for differentiating the origin of outflow tract ventricular arrhythmias (OT-VAs) with precordial transition in lead V
.
A total of 147 consecutive patients with OT-VAs displaying precordial transition in lead V
who underwent successful catheter ablation in the right ventricular outflow tract (RVOT) (n = 118) or left ventricular outflow tract (LVOT) (n = 29) were included in this study. The V
-V
transition index was defined as the sum of S-wave amplitude in lead V
and V
during premature ventricular contractions (PVCs) divided by the S-wave amplitude during sinus rhythm (SR), respectively, minus the sum of R-wave amplitude in lead V
, V
, and V
during PVCs divided by the R-wave amplitude during SR, respectively, i.e., [(S
/S
)V
+ (S
/S
)V
] - [(R
/R
) V
+ (R
/R
)V
+ (R
/R
)V
].
The V
-V
transition index was significantly higher for RVOT origins than for LVOT origins (1.25 ± 2.48 vs. - 3.94 ± 3.11; P < 0.001). Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.931 for the V
-V
transition index, and a cutoff value of > - 1.60 predicted a RVOT origin with a 93% sensitivity and 86% specificity. With respect to AUC and accuracy, the V
-V
transition index was superior to any previously proposed ECG indices for differentiating left from right OT-VAs. In 37 prospective cases, the new index was able to predict the site of a RVOT origin with 95% accuracy (35 of 37 cases).
The V
-V
transition index is a useful novel ECG criterion for distinguishing left from right OT-VAs with precordial transition in lead V
.</abstract><cop>Netherlands</cop><pmid>31478158</pmid><doi>10.1007/s10840-019-00612-0</doi><orcidid>https://orcid.org/0000-0003-0482-0738</orcidid><orcidid>https://orcid.org/0000-0001-8924-8261</orcidid><orcidid>https://orcid.org/0000-0002-7777-574X</orcidid><orcidid>https://orcid.org/0000-0001-5510-1253</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | EISSN: 1572-8595 |
| ispartof | Journal of interventional cardiac electrophysiology, 2019-10, Vol.56 (1), p.37 |
| issn | 1572-8595 |
| language | eng |
| recordid | cdi_pubmed_primary_31478158 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adolescent Adult Aged Catheter Ablation Diagnosis, Differential Electrocardiography - methods Epicardial Mapping Female Humans Male Middle Aged Tachycardia, Ventricular - diagnosis Tachycardia, Ventricular - physiopathology Tachycardia, Ventricular - surgery Ventricular Outflow Obstruction - diagnosis Ventricular Outflow Obstruction - physiopathology Ventricular Outflow Obstruction - surgery Ventricular Premature Complexes - diagnosis Ventricular Premature Complexes - physiopathology Ventricular Premature Complexes - surgery |
| title | The V 1 -V 3 transition index as a novel electrocardiographic criterion for differentiating left from right ventricular outflow tract ventricular arrhythmias |
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