Prevalence and electrocardiographic characteristics of idiopathic ventricular arrhythmia originating in the free wall of the right ventricular outflow tract.
BACKGROUND
The prevalence and ECG characteristics of idiopathic ventricular arrhythmia originating in the free wall of the right ventricular outflow tract (RVOT) require further clarification, which was the aim of the present study of 110 patients with idiopathic ventricular tachycardia (n=34) or premature ventricular contraction (n=76; OT-VT/PVC) who underwent successful catheter ablation at the RVOT.


RESULTS
Ten OT-VT/PVCs (9%) were ablated successfully at the free wall (FW-VT/PVC); the remaining 100 (91%) were ablated at the RVOT septum (Sep-VT/PVC). R wave amplitudes in the inferior leads were significantly smaller in FW-VT/PVC than in Sep-VT/PVC (p<0.01). An RR' pattern in the inferior leads was observed significantly more often in FW-VT/PVC than in Sep-VT/PVC (p<0.001). QS-wave amplitude in each of leads V(1) to V(3) was significantly deeper in FW-VT/PVC than in Sep-VT/PVC (p<0.001). ECG criteria requiring an RR' pattern in all inferior leads as well as an S-wave amplitude of at least 3.0 mV in lead V(2) differentiated FW-VT/PVC from Sep-VT/PVC with high sensitivity, specificity, and predictive accuracy.


CONCLUSIONS
Although FW-VT/PVC has a relatively low prevalence, it has several distinctive ECG characteristics and detailed ECG analysis can differentiate it from Sep-VT/PVC.
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. tada.h@cvc.pref.gunma.jp
Hiroshi
H
Tada
Sachiko
S
Ito
Shigeto
S
Naito
Kenji
K
Kurosaki
Marehiko
M
Ueda
Goro
G
Shinbo
Hiroshi
H
Hoshizaki
Shigeru
S
Oshima
Akihiko
A
Nogami
Koichi
K
Taniguchi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017180:Tachycardia, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*