Key result
Abnormal signal average electrocardiogram was found in 11.4% of patients with RVOT-PVC and was associated with mild RV dilation (40% vs 9%, P=0.005) and NSVT (50% vs 10.5%, P=0.001).
Why the study?
Does signal average electrocardiogram (SAECG) identify high-risk features for ARVC in patients with idiopathic RVOT-PVC?
Observational (n=88)
Does signal average electrocardiogram (SAECG) identify high-risk features for ARVC in patients with idiopathic RVOT-PVC?
Answers are grounded in this paper and cite their sources.
A subset of patients with idiopathic RVOT-PVC have abnormal SAECG associated with mild RV abnormalities and NSVT, suggesting a potential role in identifying early ARVC.
Background: The role of signal average electrocardiogram (SAECG) has not been studied in patients with frequent right ventric- ular outflow tract (RVOT) Premature Ventricular Contraction (PVC), therefore we decided to perform noninvasive tests including SAECG in these patients, and compare various parameters in two groups with normal and abnormal SAECG; and therefore deter- mine whether it can provide a noninvasive method to recognize high risk patients with respect to Arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods: Eighty-eight consecutive patients with right ventricular outflow tract PVC without structural heart disease were prospec- tively enrolled in this study. History report, SAECG, maximum QRS duration in right precordial leads; nadir S to isoelectric line in V1, maximum QRS ratio (ratio of QRS duration in leads V1 + V2 + V3/V4 + V5 + V6), LVEF and RV abnormalities by echocardiography, presence of VT during 24-hour holter monitoring, and response of PVC during EST were done in all of the study groups. Results: Signal Average Electrocardiogram was abnormal in 11.4% of patients. The following measurements were recorded for pa- tients with abnormal SAECG versus normal SAECG: QRS duration in right precordial leads (mean SD: 107.6 6.9 versus 90.8 9.2, P < 0.001): Nadir S to isoelectric line (mean SD:50.2 5.8 versus 44.2 5.2, P = 0.001): mild RV dilation (40% versus 9%, P = 0.005), mild RV systolic dysfunction (60% versus 9%, P < 0.001), NSVT in holter (50% versus 10.5%, P = 0.001), and filtered QRS duration (118.5 15.9 versus 99.9 13.1, P < 0.001). Conclusions: Patients with idiopathic RVOT-PVC may have abnormal SAECG. Progression of the patients with abnormal SAECG to apparent ARVC is unknown. In order to assess the natural history of the disease, the patients should be kept under close observation until further information is available.
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Alizadeh et al. (2016) conducted an observational in Right ventricular outflow tract Premature Ventricular Contraction (RVOT-PVC) (n=88). Abnormal Signal Average Electrocardiogram (SAECG) vs. Normal SAECG was evaluated on Frequency of abnormal SAECG and associated electrocardiographic and echocardiographic parameters. Abnormal signal average electrocardiogram was found in 11.4% of patients with RVOT-PVC and was associated with mild RV dilation (40% vs 9%, P=0.005) and NSVT (50% vs 10.5%, P=0.001).
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