Key result
PVC QRS-to-His interval ≥88 ms identifies epicardial origin.
Why the study?
Criteria were needed to define the localization of ventricular arrhythmias.
Does the interval from PVC QRS onset to His potential and its ratio to QRS duration accurately identify the epicardial origin of PVC/VT in patients with ventricular arrhythmias?
Observational (n=40)
Does the interval from PVC QRS onset to His potential and its ratio to QRS duration accurately identify the epicardial origin of PVC/VT in patients with ventricular arrhythmias?
The interval from PVC QRS onset to His potential and its ratio to QRS duration are useful new electrophysiological parameters for differentiating epicardial from endocardial origins of ventricular arrhythmias.
May aid epicardial PVC localization during ablation; leaves open prospective validation before clinical adoption.
Aim: The study defines criteria for localization of ventricular arrhythmias. Materials & methods: Data from 40 premature ventricular complex (PVC)/ventricular tachycardia (VT) were studied. The interval from PVC QRS onset to His potential and ratio of this interval to PVC/VT QRS duration was analyzed. Patients were divided into epicardial and endocardial groups based on mapping/successful ablation site. Results: The interval from PVC QRS onset to His potential in the epicardial versus endocardial group was 99 ± 21 ms and 64 ± 37 ms (p = 0.002). A cut off of 88 ms had a sensitivity of 73% and specificity of 76%. A cut off of 0.50 for the ratio had a sensitivity of 82% and specificity of 72%. Conclusion: Two new parameters can help localization of PVC/VTs origin.
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Jain et al. (2020) conducted an observational in Premature ventricular complex (PVC) / ventricular tachycardia (VT) (n=40). Interval from PVC QRS onset to His potential vs. Endocardial origin was evaluated on Interval from PVC QRS onset to His potential (p=0.002). An interval from PVC QRS onset to His potential ≥88 ms identified epicardial origin with 73% sensitivity and 76% specificity (99 vs 64 ms for epicardial vs endocardial, p=0.002).
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