The value of right precordial lead ECG in differentiating left from right ventricular origin in patients with outflow tract premature ventricular contraction
Abstract：Objective To evaluate the value of right precordial lead ECG on distinguishing the origin of outflow tract premature ventricular contraction(PVC). Methods Eightyfive patients with outflow tract PVC at an average age of (46.28±14.70) years old were selected in our study who had successively undergone catheter radiofrequency ablation. According to the origin of PVC, they were divided into right ventricular outflow tract(RVOT) group with 64 cases and left ventricular outflow tract(LVOT) group with 21 cases. Standard 12-lead and right precordial lead(V3R, V4R, V5R) ECG were separately recorded before the ablation. Right precordial lead ECG indexes including R- and S-wave amplitudes, and R-wave amplitude ratio were retrospectively analyzed, and a novel electrocardiographic algorithm based on right precordial leads was developed. The successfully ablated target was defined as the origin site of PVC. Results In the occurrence of PVC, the R-wave amplitude ratio of lead V3Rin RVOT group was significantly lower than that in LVOT group [(0.26±0.21) vs. (0.77±0.33), P＜0.001]. The area under curve(AUC) of V3R R-wave amplitude ratio was greater than that of V4R and V5R R-wave amplitude ratio(AUC=0.849, 0.781 and 0.697, respectively). The critical value of V3RR-wave amplitude ratio was 0.41 with a sensitivity of 81.4% and a specificity of 83.3% in differentiating left from right ventricular origin among PVC patients. Conclusion Right precordial lead ECG could initially determine the origin of PVC between LVOT and RVOT foci before procedure, which is helpful to develop the ablation strategies.
陆振钧, 陈灿曦, 邓国法, 杨希, 贾月贞, 徐健, 程典. 运用右胸导联心电图鉴别流出道室性早搏的左右室起源[J]. 实用心电学杂志, 2018, 27(6): 397-400.
LU Zhen-Jun, CHEN Can-Xi, DENG Guo-Fa, YANG Xi, JIA Yue-Zhen, XU Jian, CHENG Dian. The value of right precordial lead ECG in differentiating left from right ventricular origin in patients with outflow tract premature ventricular contraction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2018, 27(6): 397-400.
2018, Vol. 27 
