Differentiating the origin of outflow tract ventricular arrhythmia using a simple, novel approach

Efimova, Elena V.; Dinov, Borislav; Acou, Willem‐Jan; Schirripa, Valentina; Kornej, Jelena; Kosiuk, Jędrzej; Rolf, Sascha; Sommer, Philipp; Richter, Sergio; Bollmann, Andreas; Hindricks, Gerhard; Arya, Arash

doi:10.1016/j.hrthm.2015.04.004

Cited by 25 publications

(25 citation statements)

References 22 publications

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“…All four cases of VA misclassified by the automated analysis originated at sites immediately bordering on the other cardiac chamber. This is in line with prior studies indicating that VAs originating from the septum of the outflow tracts are likewise commonly misclassified by other algorithms since they might have exits at both sides . Whether photographic documentation and integration of the actual precordial lead positions or a comparison between the QRS morphology of intrinsically conducted beats and PVCs for the given electrode positions could further increase the accuracy of the automated algorithm will have to be assessed in further studies.…”

Section: Discussionsupporting

confidence: 80%

Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia

Asatryan

Ebrahimi

Strebel

et al. 2019

Cardiovasc electrophysiol

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Background: Radiofrequency catheter ablation of idiopathic ventricular arrhythmias (VAs) is performed to eliminate symptoms and to prevent or reverse arrhythmia-induced cardiomyopathy. Preprocedural prediction of the chamber of VA origin is critical for patient counseling, procedure planning, and guidance of invasive mapping.Objective: We aimed to assess the performance of manual expert versus automated 12-lead electrocardiogram (ECG) analysis in the prediction of VA origin.Methods: Patients with ablation of idiopathic VA and sustained success were included. The VA origin was defined as the site where ablation caused arrhythmia suppression. Standard baseline 12-lead ECGs with documentation of the VA were analyzed manually in a blinded fashion by three electrophysiologists and three electrophysiology (EP) fellows. In addition, the same standard 12-lead ECG was analyzed by an automated computer algorithm using a vectorcardiographic approach.Results: Thirty-eight patients (median age, 47 [interquartile range, 37-58]; 68% female) were enrolled. The VA originated from the right ventricle in 24 (63%) and the left ventricle in 14 (37%) patients. The electrophysiologists and EP fellows identified the VA chamber of origin with a similar accuracy of 73% and 72% (P = .72). The automated algorithm showed a higher accuracy of 89% (P = .03 compared with electrophysiologists and EP fellows). This resulted in a sensitivity of 95% and specificity of 86%.Conclusion: While the manual ECG analysis of the standard 12-lead ECG by both electrophysiologists and EP fellows correctly identified the chamber of VA Babken Asatryan and Ramin Ebrahimi contributed equally to this work and are co-first authors.

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Section: Discussionsupporting

confidence: 80%

Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia

Asatryan

Ebrahimi

Strebel

et al. 2019

Cardiovasc electrophysiol

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“…The depolarization polarity is different in patients with ACC‐VA and RVOT‐VA. In the study by Efimova et al., they measured the interval from the QRS onset to the electrogram placed in the right ventricle apex (RVA) and found that ACC‐VA tend to have a longer QRS‐RVA interval than the RVOT‐VA. In the study by Nakano et al., they found that the synthesized right‐sided chest leads (V3R‐V5R) are useful in differentiating the ACC‐VA from the RVOT‐VA.…”

Section: Discussionmentioning

confidence: 99%

Multiple Intercostal Space Electrocardiogram Allows Accurate Localization of Outflow Tract Ventricular Arrhythmia Origin

Liu

Jia

Ren

et al. 2015

Pacing Clinical Electrophis

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“…Therefore, through analyzing the features of ECG, an accurate prediction of the OT-VA origins before the procedure can optimize the ablation result, reduce ablation duration, and avoid eventual operative complications. In fact, numerous studies [3][4][5][6][7][8][9][10][11] have already revealed a strong relationship between the characteristics of ECG and the sites (RVOT or LVOT) where OT-VA stems from.…”

Section: Background and Summarymentioning

confidence: 99%

“…Label selection. The available sites classification studies listed in 3,[5][6][7][8][9][10][11] were designed to distinguish LVOT and RVOT per patient. However, the sub locations under RVOT or LVOT are also important from a clinical prospective.…”

Section: Technical Validationmentioning

confidence: 99%

A 12-Lead ECG database to identify origins of idiopathic ventricular arrhythmia containing 334 patients

Zheng

Anderson

et al. 2020

Sci Data

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Cardiac catheter ablation has shown the effectiveness of treating the idiopathic premature ventricular complex and ventricular tachycardia. As the most important prerequisite for successful therapy, criteria based on analysis of 12-lead ECGs are employed to reliably speculate the locations of idiopathic ventricular arrhythmia before a subsequent catheter ablation procedure. Among these possible locations, right ventricular outflow tract and left outflow tract are the major ones. We created a new 12-lead ECG database under the auspices of Chapman University and Ningbo First Hospital of Zhejiang University that aims to provide high quality data enabling detection of the distinctions between idiopathic ventricular arrhythmia from right ventricular outflow tract to left ventricular outflow tract. The dataset contains 334 subjects who successfully underwent a catheter ablation procedure that validated the accurate origins of idiopathic ventricular arrhythmia.

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Differentiating the origin of outflow tract ventricular arrhythmia using a simple, novel approach

Cited by 25 publications

References 22 publications

Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia

Man vs machine: Performance of manual vs automated electrocardiogram analysis for predicting the chamber of origin of idiopathic ventricular arrhythmia

Multiple Intercostal Space Electrocardiogram Allows Accurate Localization of Outflow Tract Ventricular Arrhythmia Origin

A 12-Lead ECG database to identify origins of idiopathic ventricular arrhythmia containing 334 patients

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