title: Premature ventricular contractions originating from the right ventricular outflow tract: three-dimensional distribution of the target sites and their electrocardiographic characteristics.
abstract: 1. The purpose of the present study was to explore the relationship between electrocardiogram (ECG) patterns of right ventricular outflow tract (RVOT) premature ventricular contractions and the three-dimensional distribution of the target sites. 2. Thirty-three consecutive patients were included in the study. The target sites were identified by non-contact mapping and confirmed by successful ablation. The distribution of the target sites in the three-dimensional reconstructed geometry of the RVOT was classified in three directions: (i) anterior (A)/posterior (P); (ii) free wall (F)/septal (Se); and (iii) superior (Su)/inferior (I). The ECG characteristics were then analysed according to the three-dimensional distribution of the target sites. 3. The following indices were helpful to identify the position of the target site: (i) QRS duration (> or = 150 msec = F; < 150 msec = Se; P < 0.05); (ii) the R wave pattern in the inferior leads (RR' or Rr' = F; R = Se; P < 0.05); (iii) the R wave amplitude in the inferior leads (high = Se; low = F; P < 0.05); (iv) the initial r wave width in lead V(1) (wide = F; narrow = Se; P < 0.05); (v) the QS wave amplitude in aVR and aVL (if aVR < aVL, A; if aVR > or = aVL, P; P < 0.05); and (vi) the initial r wave amplitude in lead V(1) and V(2) (if V(1) > or = 0.15 mV and V(2) > or = 0.3 mV, Su; if V(1) < 0.15 mV or V(2) < 0.3 mV, I; P < 0.05). 4. In conclusion, the ECG characteristics were associated with target site locations in all three directions.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yu
authors.forename: Bing
authors.initials: B
authors.lastname: Yang
authors.forename: Ming-Long
authors.initials: ML
authors.lastname: Chen
authors.forename: Hong-Wu
authors.initials: HW
authors.lastname: Chen
authors.forename: Wei-Zhu
authors.initials: WZ
authors.lastname: Ju
authors.forename: Qi-Jun
authors.initials: QJ
authors.lastname: Shan
authors.forename: Jian-Gang
authors.initials: JG
authors.lastname: Zou
authors.forename: Chun
authors.initials: C
authors.lastname: Chen
authors.forename: Dong-Jie
authors.initials: DJ
authors.lastname: Xu
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Hou
authors.forename: Ke-Jiang
authors.initials: KJ
authors.lastname: Cao
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization; D017115:Catheter Ablation; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery