METHODS: We studied consecutive patients with idiopathic VAs originating from the LVS (67 patients) and aortic root (93 patients).
RESULTS: Based on the ablation results, among 67 LVS VAs, 54 were classified as lateral and 13 as septal-LVS VAs. As compared with the lateral-LVS VAs, the septal-LVS VAs were characterized by a greater prevalence of left bundle branch block with left inferior-axis QRS pattern, later precordial transition, lower R-wave amplitude ratio in leads III to II, lower Q-wave amplitude ratio in leads aVL to aVR, and later local ventricular activation time relative to the QRS onset during VAs (V-QRS) in the great cardiac vein. The electrocardiographic and electrophysiological characteristics of the septal-LVS VAs were similar to those of the aortic root VAs. However, the V-QRS at the successful ablation site was significantly later during the septal-LVS VAs than aortic root VAs (p < .0001). The precordial transition was significantly later during the septal-LVS VAs than aortic root VAs (p < .05).
CONCLUSIONS: Septal-LVS VAs are considered a distinct subgroup of idiopathic VAs originating from the left ventricular outflow tract.
方法:我们研究了来自LVS(67例)和主动脉根部(93例)的特发性VAs的连续患者。
结果:根据消融结果,在67个LVSVAs中,54个被分类为外侧,13个被分类为间隔LVSVA。与横向LVSVA相比,室间隔-LVSVAs的特征是左束支传导阻滞伴左下轴QRS图的患病率更高,后来的心前过渡,导线III至II中的较低R波振幅比,较低的Q波振幅比在引线aVL到aVR,以及相对于心脏大静脉中的VAs(V-QRS)期间QRS发作的局部心室激动时间。间隔LVSVA的心电图和电生理特征与主动脉根VA相似。然而,在间隔LVSVAs期间,成功消融部位的V-QRS明显晚于主动脉根部VAs(p<.0001)。在间隔-LVSVAs期间,心前区转变明显晚于主动脉根VAs(p<0.05)。
结论:Septal-LVSVAs被认为是起源于左心室流出道的特发性VAs的独特亚组。