Key result
A simple clinical score comprising hypertension, male gender, and age >50 years predicted left ventricular outflow tract origin of ventricular arrhythmias with 80% sensitivity and 75% specificity.
Why the study?
Does a simple clinical score using hypertension, male gender, and age >50 years predict LVOT origin in patients with outflow tract ventricular arrhythmias?
Observational (n=260)
Yes
Does a simple clinical score using hypertension, male gender, and age >50 years predict LVOT origin in patients with outflow tract ventricular arrhythmias?
p-value: p=<0.001
A simple clinical score based on age, gender, and hypertension can predict a left ventricular outflow tract origin of ventricular arrhythmias with high sensitivity and specificity.
May guide initial mapping in outflow tract VA ablation; leaves open prospective validation before clinical adoption.
AIMS: To identify clinical characteristics able to predict a left ventricular outflow tract (LVOT) origin in outflow tract ventricular arrhythmias (OTVAs). METHODS AND RESULTS: We included 117 consecutive patients (training sample) with successful radiofrequency ablation of OTVA in one centre. A predictive model for LVOT origin was obtained using clinical data. The model was prospectively validated in a second population (testing sample) of 143 patients from two additional centres. In training sample, mean age was 54 ± 17 years, 72 patients (61%) were male, and 63 (54%) had cardiovascular risk factors. Sixty (51%) patients had LVOT origin. Independent predictors for LVOT origin were the presence of hypertension [odds ratio (OR) 2.17, confidence interval (CI) 0.91-6.20, P = 0.09], male gender (OR 4.83, 95% CI 1.89-12.33, P < 0.001), and age >50 years (OR 4.46, 95% CI 1.57-12.7, P = 0.005). A simple score was constructed with these three variables to predict LVOT origin (mean predicted probability of 15% for score 0, 26% for score 1, 60% for score 2, and 87% for score 3, P < 0.001) and reached 80% sensitivity and 75% specificity. The score was validated in the testing sample and was not inferior to previously described electrocardiogram algorithms. CONCLUSION: Patients currently referred for OTVA ablation are older, more frequently men, and with a higher probability for LVOT origin than previously described. A LVOT origin is associated with the presence of hypertension, male gender, and older age, and can be anticipated by using a simple clinical score.
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Penela et al. (2015) conducted an observational in Outflow tract ventricular arrhythmias (n=260). Clinical score (hypertension, male gender, age >50 years) vs. Previously described electrocardiogram algorithms was evaluated on Left ventricular outflow tract (LVOT) origin (p=<0.001). A simple clinical score comprising hypertension, male gender, and age >50 years predicted left ventricular outflow tract origin of ventricular arrhythmias with 80% sensitivity and 75% specificity.
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