Abstract 8791: Novel ECG Criteria Identifying Posteroseptal Right Ventricular Outflow Tract Arrhythmia
Background: Some studies have shown ECG characteristics of outflow tract ventricular arrhythmia (OT-VA), however, most of the studies mainly focused on prediction of LVOT or RVOT origin. The detail of 12-lead ECG characteristics of septal right ventricular outflow tract arrhythmia (RVOT-VA) remains unknown.
Purpose: The purpose of this study is to elucidate the predictability of the site of origin in septal RVOT-VA by 12-lead ECG characteristics.
Method: A total of 56 consecutive patients underwent radiofrequency catheter ablation (RFCA) in our institution from 2006 to 2009. Among them, 32 patients (59%) with septal RVOT-VA were retrospectively reviewed. They were divided into 3 groups according to the ablation success site, anteroseptal RVOT (Group A, n=9), posteroseptal RVOT (Group P, n=9), and midseptal RVOT (Group M, n=14).
Result: Baseline characteristics such as age, sex, etc. did not show significant difference in each group. Compared with other groups, Group P showed significantly higher rate of R or rS pattern in lead I (Group P: 100%, Group A: 11%, Group M:36%, p<0.0001). Existence of r-wave (>0.1mV) in V1 was recognized more frequently in Group P than Group A and Group M (89%, 33%, 50%, respectively, p<0.05). Also, the ratio of V1/V2 Q-wave amplitude was significantly higher in Group P (0.75, 0.51, 0.58, p<0.01). We could predict the site of origin was posteroseptal RVOT if the 12-lead ECG met those 3 criteria of R or rS pattern in lead I, existence of r-wave (>0.1mV) in V1, and ratio of V1/V2 > 0.6 (sensitivity 89%, specificity 100%).
Conclusion: In this study, we could predict the posteroseptal RVOT origin among septal RVOT-VAs if the 12-lead ECG satisfied these 3 criteria (Figure).
- © 2011 by American Heart Association, Inc.