Characteristics of electrocardiogram and vectorcardiogram of idiopathic ventricular premature contraction originating from right ventricular outflow tract septum
Abstract:Objective To investigate the characteristics of electrocardiogram(ECG) and vectorcardiogram(VCG) of idiopathic ventricular premature contraction(IPVC) originating from right ventricular outflow tract septum(RVOTS) verified by radiofrequency ablation(RFA). Methods We collected and analyzed the parameters of 12 lead ECG and Frank lead VCG among 14 RVOTS originated IPVC patients verified by RFA with CARDIOView ECG workstation. Results In 12 lead ECG, RVOTS originated IPVC was shaped like left bundle branch block. There were 12 cases(85.7%) with precordial transition ratio≥0, 14 cases(100%) with Rwave duration index<50% in lead V2, 13 cases(92.9%) with R/Swave amplitude index<30% in lead V2, and 12 cases(85.7%) with SV2/RV3 index>1.5. The characteristics of VCG were as follows. In F plane, QRS loop operated in a clockwise(CW) and counterclockwise(CCW) direction in 5 cases(35.7%) respectively; in H plane, it operated in CCW direction in 10 cases(71.4%); in S plane, its operating direction was CW in all the cases(100%); at the first 0.04 s, the amplitude of QRS loop gradually increased, and most of it was oriented leftward, anteriorly and inferiorly; In the period of 0.01[CD*2]0.04 s, leftward vectors gradually increased while anterior ones gradually decreased; the largest vector of QRS loop and the majority of its area was located leftward, inferiorly and backward. Conclusion ECG is proved to have high accuracy in the location and diagnosis of RVOTS originated IPVC. Typical characteristics of VCG are found in RVOTS originated IPVC.
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