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Date Published: 26/08/2022
Abstract Views: 249
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DOI: https://doi.org/10.51298/vmj.v517i2.3281
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Vol. 517 No. 2 (2022)
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Các bài báo
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Văn Hoàng, Đặng ., Ngọc Cầm, T. ., Việt Dũng, N. ., Hoàng Long, V. ., Trần Linh, P. ., & Lân Hiếu, N. . (2022). THE ROLE OF MODIFIED ECG LEADS IN THE DIFFERENTIAL DIAGNOSIS OF PREMATURE VENTRICULAR COMPLEXES FROM THE RIGHT VENTRICULAR OUTFLOW TRACT AND THE LEFT VENTRICULAR OUTFLOW TRACT. Vietnam Medical Journal, 517(2). https://doi.org/10.51298/vmj.v517i2.3281

THE ROLE OF MODIFIED ECG LEADS IN THE DIFFERENTIAL DIAGNOSIS OF PREMATURE VENTRICULAR COMPLEXES FROM THE RIGHT VENTRICULAR OUTFLOW TRACT AND THE LEFT VENTRICULAR OUTFLOW TRACT

Đặng Văn Hoàng1,, Trần Ngọc Cầm2,3, Nguyễn Việt Dũng2,3, Viên Hoàng Long2,3, Phạm Trần Linh2,3, Nguyễn Lân Hiếu1
1 Hanoi Medical University
2 Vietnam National Heart Institute, Bach Mai Hospital
3 University of Medicine and Pharmacy, Vietnam National University, Hanoi

Main Article Content

Abstract

Background: The ventricular arrhythmias without structural heart disease, also known as idiopathic ventricular arrhythmias, mostly originate in the ventricular outflow tracts. Distinguishing between premature complexes originating from right ventricular outflow tract and left ventricular outflow tract is still difficult, especially premature ventricular complex with left bundle branch block pattern with transition at V3. Objectives: Evaluation of the role of modified ECG leads in the differential diagnosis of premature ventricular complexes from the right ventricular outflow tract and the left ventricular outflow tract. Methods: Cross-sectional study 70 patients with premature ventricular complexes without structural heart disease, with indications for electrophysiology study and RF treatment. Results: Out of 70 patients with premature ventricular complexes originating from ventricular outflow tracts. The patients underwent electrophysiology study and successful RF ablation in the right ventricular outflow tract (RVOT: n=47) and left ventricular outflow tract (LVOT; n=23). Regarding the value of differential diagnosis of ventricular ectopy location, R wave amplitude index, S wave amplitude, R/S amplitude ratio, RWDI are valuable for differential diagnosis of ventricular outflow tract ectopy. RWDI is the index with the highest diagnostic value in the general study group and the group with electrocardiogram transition at V3. With the RWDI value ≤40 ms, the sensitivity is 95.7%, the specificity is 95.7% and the area under the AUC curve was 0.96 (95% CI 0.91-1.00) in the diagnosis of RVOT PVC in the study group. When comparing the RWDI index with some previous diagnostic criteria of the standard electrocardiogram in the general patient group and the group with transition at V3, the RWDI index proves to excel in terms of under-the-curve values ​​as well as high sensitivity and specificity. Conclusion: New diagnostic criteria of modified electrocardiogram leads are valuable in  the differential diagnosis of premature ventricular complexes originating from ventricular outflow tracts, among which the RWDI is the most valuable index in differential diagnosis and useful in clinical practice.

Article Details

Keywords

modified ECG leads, premature ventricular complex, ventricular outflow tracts

References

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