Value of a Posterior Electrocardiographic Lead for Localization of Ventricular Outflow Tract Arrhythmias: The V4 /V8 Ratio

JACC. Clinical Electrophysiology
Fengxiang ZhangRoderick Tung

Abstract

This study sought to prospectively evaluate the value of a dedicated electrocardiographic posterior lead to create an anteroposterior ratio to localize premature ventricular complexes (PVCs) between the right ventricular outflow tract and left ventricular outflow tract for catheter ablation. The anteroposterior relationship between the right and left outflow tract has not been explored for electrocardiographic localization of ventricular arrhythmia. Standard V5 and V6 leads were placed posteriorly and ablation was performed with activation mapping. The site of successful ablation was correlated with the ratio of the R-wave in V4 to the R-wave in V8. Normalization of the V4/V8 ratio to a V4/V8 index was achieved by dividing the V4/V8 ratio by sinus V4/V8. After determination of optimal cutoffs, comparison with V2 transition ratio and V2S/V3R was subsequently performed using receiver operating characteristic curves in a prospective validation cohort. A total of 134 patients underwent ablation of PVCs with 2 modified posterior leads. PVCs successfully ablated from the left side had a statistically significantly higher V4/V8 ratio compared with right-sided PVCs (11.7 ± 10.6 vs. 2.3 ± 2.4, p < 0.001). At a cutoff of >3, the V4/V8 ra...Continue Reading

References

Feb 1, 2005·Journal of the American College of Cardiology·Hildegard TannerHans Kottkamp
Jan 26, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Rupa BalaFrancis E Marchlinski
May 28, 2011·Journal of the American College of Cardiology·Brian P BetenskyEdward P Gerstenfeld
Dec 14, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Elad AnterSanjay Dixit
Nov 5, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Lidia Carballeira PolFrancis E Marchlinski
Jan 8, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Miyako IgarashiKazutaka Aonuma
Apr 8, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Elena EfimovaArash Arya

❮ Previous
Next ❯

Citations

Feb 6, 2019·International Journal for Numerical Methods in Biomedical Engineering·Ruben DosteOscar Camara
Jun 5, 2019·Circulation. Arrhythmia and Electrophysiology·Robert D AndersonGeoffrey Lee
Oct 28, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Carlo LavalleFrancesco Fedele
May 4, 2021·Arrhythmia & Electrophysiology Review·Marco V MarianiCarlo Lavalle
Aug 23, 2021·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Robert D Anderson, Geoffrey Lee

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Regeneration

Cardiac regeneration enables the repair of irreversibly damaged heart tissue using cutting-edge science, including stem cell and cell-free therapy. Discover the latest research on cardiac regeneration here.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.