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- Title
Validation of a clinical model for predicting left versus right ventricular outflow tract origin of idiopathic ventricular arrhythmias.
- Authors
Bourquin, Luc; Küffer, Thomas; Asatryan, Babken; Badertscher, Patrick; Baldinger, Samuel H.; Knecht, Sven; Seiler, Jens; Spies, Florian; Servatius, Helge; Kühne, Michael; Noti, Fabian; Osswald, Stefan; Haeberlin, Andreas; Tanner, Hildegard; Roten, Laurent; Reichlin, Tobias; Sticherling, Christian
- Abstract
Background: Prediction of the chamber of origin in patients with outflow tract ventricular arrhythmias (OTVA) remains challenging. A clinical risk score based on age, sex and presence of hypertension was associated with a left ventricular outflow tract (LVOT) origin. We aimed to validate this clinical score to predict an LVOT origin in patients with OTVA. Methods: In a two‐center observational cohort study, unselected patients undergoing catheter ablation (CA) for OTVA were enrolled. All procedures were performed using an electroanatomical mapping system. Successful ablation was defined as a ≥80% reduction of the initial overall PVC burden after 3 months of follow‐up. Patients with unsuccessful ablation were excluded from this analysis. Results: We included 187 consecutive patients with successful CA of idiopathic OTVA. Mean age was 52 ± 15 years, 102 patients (55%) were female, and 74 (40%) suffered from hypertension. A LVOT origin was found in 64 patients (34%). A score incorporating age, sex and presence of hypertension reached 73% sensitivity and 67% specificity for a low (0–1) and high (2–3) score, to predict an LVOT origin. The combination of one ECG algorithm (V2S/V3R‐index) with the clinical score resulted in a sensitivity and specificity of 81% and 70% for PVCs with R/S transition at V3. Conclusion: The published clinical score yielded a lower sensitivity and specificity in our cohort. However, for PVCs with R/S transition at V3, the combination with an existing ECG algorithm can improve the predictability of LVOT origin.
- Subjects
ARRHYTHMIA treatment; HYPERTENSION; AGE distribution; RETROSPECTIVE studies; CATHETER ablation; VENTRICULAR tachycardia; RISK assessment; SEX distribution; VENTRICULAR arrhythmia; THEORY; DESCRIPTIVE statistics; ELECTROCARDIOGRAPHY; ARRHYTHMIA; PREDICTION models; SENSITIVITY &; specificity (Statistics); LONGITUDINAL method; ALGORITHMS; DISEASE risk factors
- Publication
Pacing & Clinical Electrophysiology, 2023, Vol 46, Issue 10, p1186
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.14809