Our aim was to validate an electrocardiographic marker of LVAs in the RVOT in patients with idiopathic outflow tract VAs.
A total of 120 patients were studied, 84 patients referred for ablation of idiopathic VAs with an inferior axis by the same operator, and a control group of 36 patients without VAs. Structural heart disease including arrhythmogenic right ventricular cardiomyopathy was ruled out in all patients. An electrocardiogram was performed with V1-V2 at the 2nd ICS, and ST-segment elevation ≥1 mm and T-wave inversion beyond V1 were assessed. Bipolar voltage map of the RVOT was performed in sinus rhythm (0.5-1.5 mV color display). Areas with electrograms <1.5 mV were considered LVAs, and their presence was assessed. We compared three groups, VAs from the RVOT (n = 66), VAs from the LVOT (n = 18) and Control group (n = 36). ST-elevation, T-wave inversion and left versus right side of the VAs were tested as predictors of LVAs, respective odds ratio (ORs) (95% confidence interval [CI]) and p values, were calculated with univariate logist regression. Variables with a p < .005 were included in the multivariate analysis.
ST-segment elevation, T-wave inversion and LVAs were present in the RVOT group, LVOT group and Control group as follows: (62%, 17%, and 6%, p < .0001), (33%, 29%, and 0%, p = .001) and (62%, 25%, and 14%, p < .0001). The ST-segment elevation, T-wave inversion and right-sided VAs were all predictors of LVAs, respective unadjusted ORs (95% CI), p values were, 32.31 (11.33-92.13), p < .0001, 4.137 (1.615-10.60), p = .003 and 8.200 (3.309-20.32), p < .0001. After adjustment, the only independent predictor of LVAs was the ST-segment elevation, with an adjusted OR (95% CI) of 20.94 (6.787-64.61), p < .0001.
LVAs were frequently present in patients with idiopathic VAs. ST-segment elevation was the only independent predictor of their presence.
我们的目的是验证特发性流出道VAs患者RVOT中LVA的心电图标记。
共研究了120名患者,84例患者被同一操作者转诊为下轴特发性VAs消融,对照组36例患者无VAs。所有患者均排除了结构性心脏病,包括致心律失常性右心室心肌病。在第2次ICS用V1-V2进行心电图检查,评估了ST段抬高≥1mm和超过V1的T波倒置。在窦性心律下进行RVOT的双极电压图(0.5-1.5mV彩色显示)。电描记图<1.5mV的区域被认为是LVAs,并评估了他们的存在。我们比较了三组,来自RVOT的VA(n=66),来自LVOT(n=18)和对照组(n=36)的VAs。ST段抬高,测试了T波反演和VAs的左右两侧作为LVAs的预测因子,各自的优势比(OR)(95%置信区间[CI])和p值,用单变量逻辑回归计算。P<.005的变量包括在多变量分析中。
ST段高程,RVOT组存在T波反转和LVAs,LVOT组和对照组如下:(62%,17%,6%,p<.0001),(33%,29%,0%,p=.001)和(62%,25%,14%,p<.0001)。ST段抬高,T波反演和右侧VAs都是LVAs的预测因子,各自未调整的OR(95%CI),p值是,32.31(11.33-92.13),p<.0001,4.137(1.615-10.60),p=.003和8.200(3.309-20.32),p<.0001。调整后,LVAs的唯一独立预测因子是ST段抬高,调整后的OR(95%CI)为20.94(6.787-64.61),p<.0001。
特发性VAs患者常出现LVA。ST段抬高是其存在的唯一独立预测因子。