A newly proposed ECG algorithm identified successful ablation sites for RVOT-VPC with a positive predictive value of 77.3%, compared to 53.8%-73.3% for existing algorithms (P>0.05).
Observational (n=52)
Does a newly proposed ECG algorithm improve the accuracy of identifying optimal target ablation sites for RVOT-VPC compared to existing algorithms?
A newly proposed ECG algorithm demonstrates high sensitivity, specificity, and positive predictive value for identifying successful ablation sites for RVOT-VPCs.
Absolute Event Rate: 77.3% vs 73.3%
p-value: p=>0.05
AIMS: Several electrocardiographic (ECG) algorithms have been developed to identify the site of origin of ventricular premature contractions (VPCs) from right ventricular outflow tract (RVOT) based on pacemapping; however, their accuracy remains unclear. METHODS AND RESULTS: We evaluated the accuracy of these algorithms in 52 consecutive patients (31 female, mean age 42.6+/-14.6 years) with successful radiofrequency ablation of RVOT-VPC as guided by 3D electroanatomical non-contact mapping (Ensite, St Jude Medical, USA) and compared with a newly proposed ECG algorithm. As guided by 3D electroanatomical mapping, the successful ablation sites of RVOT-VPC were RVOT septum (n=31), RVOT free wall (n=19), and His region (n=2). Retrospective evaluation in the initial 39 patients shows that the overall positive prediction value to identify a successful ablation site of this newly proposed ECG algorithm is 77.3% and is higher than the 73.3% by Ito et al., 73.3% by Joshi et al., and 53.8% by Dixit et al. (P>0.05). Prospective evaluation in the subsequent 13 patients also demonstrate similar high overall sensitivity (79.0%), specificity (92.7%), and positive prediction value (88.2%) to identify a successful ablation site with this newly proposed ECG algorithm. CONCLUSION: On the basis of detail 3D electroanatomical mapping of successful ablation sites, a newly proposed ECG algorithm was developed to improve the sensitivity, specificity, and positive prediction value in identification of targeted ablation sites for RVOT-VPC.
Zhang et al. (2009) conducted an observational in Idiopathic right ventricular outflow tract ventricular premature contraction (n=52). Newly proposed ECG algorithm vs. Existing ECG algorithms (Ito et al., Joshi et al., Dixit et al.) was evaluated on Positive prediction value to identify a successful ablation site (p=>0.05). A newly proposed ECG algorithm identified successful ablation sites for RVOT-VPC with a positive predictive value of 77.3%, compared to 53.8%-73.3% for existing algorithms (P>0.05).