Electrocardiographic characteristics differentiating epicardial outflow tract-ventricular arrhythmias originating from the anterior interventricular vein and distal great cardiac vein

Circulation Journal : Official Journal of the Japanese Circulation Society
Hitoshi HachiyaY Iesaka

Abstract

The aim of this study was to identify the ECG features that might differentiate between anterior interventricular vein (AIV) and distal great cardiac vein (d-GCV) outflow tract-ventricular arrhythmias (OT-VAs). Radiofrequency catheter ablation was performed in 13 of 375 patients (3.5%) for AIV or d-GCV OT-VAs. We grouped the 13 patients by the origin, d-GCV (n=9) or AIV (n=4), and compared their ECGs and electrophysiological data. The OT-VA ECGs had S waves in lead I in all 13 patients. The voltage in the inferior lead III and peak deflection index showed no significant between-group differences (2.3±0.7 vs. 2.5±0.3 mV and 0.65±0.04 vs. 0.68±0.04 mV, respectively) for the d-GCV and AIV groups. There were also no significant between-group differences in the QaVL/QaVR, where Q denotes the amplitude of the Q wave in the suffix lead. However, the R/S ratio in V1 (1.7±1.0 [n=5] vs. 0.2±0.05, P=0.04), and QRS duration (149±16.6 vs. 123±3.8 ms, P=0.012) were greater in the d-GCG group than in the AIV group. There were no significant between-group differences in the activation time or pace mapping score at the optimal ablation sites. A low R/S ratio in V1 and shorter QRS duration may help identify AIV sites of epicardial OT-VA origin.

References

Jul 11, 2002·Journal of Cardiovascular Electrophysiology·Hitoshi HachiyaYoshito Iesaka
Mar 16, 2005·Journal of the American College of Cardiology·Hiroshi TadaKoichi Taniguchi
Sep 30, 2005·Journal of Cardiovascular Electrophysiology·Koji KumagaiKazutaka Aonuma
Sep 30, 2005·Journal of Cardiovascular Electrophysiology·Yoshihide TakahashiMichel Haïssaguerre
Jun 2, 2007·American Heart Journal·Harold S Sacks, John N Fain
Dec 17, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Hitoshi HachiyaMitsuaki Isobe
Sep 22, 2010·Circulation. Arrhythmia and Electrophysiology·Takumi YamadaG Neal Kay
May 14, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasuaki TanakaMitsuaki Isobe
Feb 7, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Miguel E Jauregui AbularachFrancis E Marchlinski
Dec 15, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenji KurosakiShinya Kowase
Jul 17, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Ioan Liuba, Francis E Marchlinski

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Citations

Jun 4, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
Aug 14, 2021·Journal of Arrhythmia·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group

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