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首页> 外文期刊>Circulation journal >Novel ECG Predictor of Difficult Cases of Outflow Tract Ventricular Tachycardia: Peak Deflection Index on an Inferior Lead
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Novel ECG Predictor of Difficult Cases of Outflow Tract Ventricular Tachycardia: Peak Deflection Index on an Inferior Lead

机译：新型的心电图预测困难病例的流出道室性心动过速：下铅的峰值偏转指数

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Background: An ECG predictor of ablation success has not been determined for difficult cases of outflow tract ventricular tachycardia/ventricular premature contractions (OT-VT/VPC). Methods and Results: ECG analysis and radiofrequency catheter ablation (RFCA) were performed in 70 patients with OT-VT/VPC. The peak deflection index (PDI) was determined in the inferior lead presenting the tallest R wave by dividing the time from QRS onset to peak QRS deflection by total QRS duration. In 10 (14%) of the 70 patients, RFCA performed at a septal or epicardial site was unsuccessful (group 1), but was successful in the remaining 60 patients (group 2). Neither activation time (35±15 ms vs 40±12 ms, P=0.3) nor QRS duration (141±19 ms vs 137±19 ms, P=0.6) were significantly different between groups 1 and 2. However, PDI was significantly higher in group 1 than in group 2 (0.62±0.06 vs 0.55±0.06, P=0.002). A PDI >0.6 identified unsuccessful OT-VT/VPC with 80% sensitivity and 90% specificity, and may indicate that the origin of the OT-VT/VPC is deep within the ventricular septum or at an epicardial site. Conclusions: A PDI >0.6 is more likely to be associated with a higher rate of RFCA failure. ( Circ J 2010; 74: 256-261)
机译：背景：尚未确定对于难于流出道室性心动过速/室性早搏（OT-VT / VPC）的病例的ECG消融成功预测指标。方法和结果：对70例OT-VT / VPC患者进行了ECG分析和射频导管消融（RFCA）。通过将从QRS发作到QRS偏转峰值之间的时间除以总QRS持续时间，可以确定在呈现最高R波的下铅中的峰偏转指数（PDI）。在70例患者中，有10例（14％）在中隔或心外膜部位进行RFCA失败（第1组），但在其余60例患者中成功（第2组）。第1组和第2组之间的激活时间（35±15 ms vs 40±12 ms，P = 0.3）和QRS持续时间（141±19 ms vs 137±19 ms，P = 0.6）均无显着差异。但是，PDI显着组1高于组2（0.62±0.06 vs 0.55±0.06，P = 0.002）。 PDI> 0.6时，发现OT-VT / VPC不成功，灵敏度为80％，特异性为90％，可能表明OT-VT / VPC的起源是在心室间隔或心外膜部位深处。结论：PDI> 0.6更有可能与更高的RFCA失败率相关。 （Circ J 2010; 74：256-261）

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