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ROLE OF V1-V3 TRANSITION INDEX IN DIFFERENTIAL DIAGNOSIS OF VENTRICULAR ARRHYTHMIAS IN THE RIGHT AND LEFT VENTRICULAR OUTFLOW TRACT
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Abstract
Introduction: Localization of premature ventricular contraction (PVC) and ventricular tachycardia (VT) on 12-lead electrocardiogram before ablation is essential. Objectives: Evaluation of the role of the V1-V3 transition index in the differential diagnosis of premature ventricular contraction and ventricular tachycardia in the right and left ventricular outflow tract. Subjects and methods: Cross-sectional, retrospective, and prospective descriptive study Results: 80 patients with idiopathic arrhythmias undergoing radiofrequency ablation (RF) were included in the study. Male : female sex ratio was 1 : 3; mean age 52,7 ± 13,5. There are 67,5% (54/80) patients with ventricular arrhythmias originating from the right ventricular outflow tract and 32,5% (26/80) patients having ventricular arrhythmias originating from the left ventricular outflow tract. The point of transition zone of PVC/VT originating from RVOT is higher than LVOT (3,44 ± 0.88 versus 1,96 ± 0.95), the difference is statistically significant with p<0,05. Transition index V1-V3 of PVC/VT from left ventricular outflow tract is lower than right ventricular outflow tract with statistical significance (- 5,22 ± 8,41 versus 2,01 ± 3,39, p<0,05). When analyzing in the group of PVC/VT with transition at V3, the V1-V3 transition index of PVC/VT from LVOT is also statistically significantly lower than the group of PVC/VT at location from RVOT ( -2,06 ± 6,02 versus 2,89 ± 6,43, with p<0,05). The transition index V1-V3 is valuable for discriminating the origin PVC/VT from RVOT and LVOT with a cut-off point of -1,02 and AUC 0,808 (0,683–0,933), with sensitivity and specificity of 89% and 81%, respectively. The V1-V3 transition index is valuable for discriminating the origin PVC/VT from RVOT and LVOT in the transition group at V3 with a cut-off point of 0,13 and AUC 0,917 (0,683–0,933), with sensitivity and specificity of 83% and 100%, respectively. Conclusion: The V1-V3 transition index of the group PVC/VT originating from the LVOT is lower than that of the group PVC/VT originating from the RVOT, with statistical significance. The V1-V3 transition index has a value in discriminating the site of onset of PVC/VT from LVOT and RVOT, with high sensitivity and specificity.
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Keywords
Premature ventricular contraction, V1-V3 transition index
References
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