1. Validation of a clinical model for predicting left versus right ventricular outflow tract origin of idiopathic ventricular arrhythmias.
- Author
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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, and Sticherling, Christian
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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 - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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