Coupling interval variability: A new diagnostic method for distinguishing left from right ventricular outflow tract origin in idiopathic outflow tract premature ventricular contractions patients with precordial R/S transition at lead V3

International Journal of Cardiology
Fen QinShenghua Zhou

Abstract

To distinguish left ventricular outflow tract (LVOT) from right ventricular outflow tract (RVOT) origin in idiopathic outflow tract premature ventricular contractions (IOT-PVCs) patients with precordial R/S transition at lead V3 is still a challenge. We sought to develop a new electrocardiography (ECG) method for distinguishing LVOT from RVOT origin in IOT-PVCs patients with precordial R/S transition at lead V3. We analyzed the surface 12-lead ECG characteristics and the difference of coupling interval variability (CIV) of PVCs between distinct origin sites in a retrospective cohort of IOT-PVCs patients with precordial R/S transition at lead V3 who underwent successful radiofrequency catheter ablation (RFCA) to develop a new diagnostic method, then validated it in a prospective cohort. A total of 196 consecutive patients (41 ± 15 years, 36.7% male) underwent RFCA of IOT-PVCs between January 2014 and August 2016. Among them, 68 patients (34.7%, 23 male) with precordial R/S transition at lead V3 constituted the retrospective cohort. Based on the areas under the receiver operating characteristic curves (AUCs), a CIV > 100 ms with the largest value of AUC was selected to develop a new diagnostic method with a specificity of 93.9% a...Continue Reading

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