Journal of cardiovascular electrophysiology · 2011
Electrocardiographic determinants of the polymorphic QRS morphology in idiopathic right ventricular outflow tract tachycardia.
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Igarashi Miyako, Tada Hiroshi, Kurosaki Kenji, Yamasaki Hiro, Akiyama Daiki, Sekiguchi Yukio, Kuroki Kenji, Machino Takeshi, Murakoshi Nobuyuki, Nakata Yoshio, Kuga Keisuke, Nogami Akihiko, Aonuma Kazutaka
Аннотация
INTRODUCTION: Premature ventricular contractions (PVCs) arising from the right ventricular outflow tract (RVOT) can trigger polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF) in patients with no structural heart disease. We aimed to clarify the ECG determinants of the polymorphic QRS morphology in idiopathic RVOT PVT/VF.
METHODS AND RESULTS: The ECG parameters were compared between 18 patients with idiopathic PVT/VF (PVT-group) and 21 with monomorphic VT arising from the RVOT (MVT-group). The coupling interval (CI) of the first VT beat was comparable between the 2 groups. However, the prematurity index (PI) of the first VT beat was smaller in the PVT-group than in the MVT-group (P < 0.001). Furthermore, the QT index, defined as the ratio of the CI to the QT interval of the preceding sinus complex, was also smaller for the PVT/VF in the PVT-group than that for the VT in the MVT-group (P < 0.01). In the PVT-group, the CI of the first VT beat was comparable between that of VT and isolated PVCs, but the PI of the first VT beat was shorter for VT than isolated PVCs (P < 0.05). The PI was the only independent determinant of the polymorphic QRS morphology (odd ratio = 2.198; 95% confidence interval = 1.321-3.659; P = 0.002).
CONCLUSION: The smaller PIs of the first VT beat may result in a polymorphic QRS morphology.
METHODS AND RESULTS: The ECG parameters were compared between 18 patients with idiopathic PVT/VF (PVT-group) and 21 with monomorphic VT arising from the RVOT (MVT-group). The coupling interval (CI) of the first VT beat was comparable between the 2 groups. However, the prematurity index (PI) of the first VT beat was smaller in the PVT-group than in the MVT-group (P < 0.001). Furthermore, the QT index, defined as the ratio of the CI to the QT interval of the preceding sinus complex, was also smaller for the PVT/VF in the PVT-group than that for the VT in the MVT-group (P < 0.01). In the PVT-group, the CI of the first VT beat was comparable between that of VT and isolated PVCs, but the PI of the first VT beat was shorter for VT than isolated PVCs (P < 0.05). The PI was the only independent determinant of the polymorphic QRS morphology (odd ratio = 2.198; 95% confidence interval = 1.321-3.659; P = 0.002).
CONCLUSION: The smaller PIs of the first VT beat may result in a polymorphic QRS morphology.
Предметные рубрики MeSH
Action PotentialsAdultAgedArrhythmias, CardiacCatheter AblationElectrocardiographyElectrophysiologic Techniques, CardiacFemaleHeart VentriclesHumansJapanLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPredictive Value of TestsRetrospective StudiesTachycardia, VentricularTime FactorsVentricular FibrillationVentricular Function, RightVentricular Premature Complexes