Novel algorithm for arrhythmogenic focus localization in patients with right ventricular outflow tract arrhythmias

Pytkowski, Mariusz; Maciąg, Aleksander; Sterliński, Maciej; Jankowska, Agnieszka; Kowalik, Ilona; Farkowski, Michał M.; Kuteszko, Rafal; Zając, Dariusz; Firek, Bohdan; Chmielak, Zbigniew; Szwed, Hanna

doi:10.5603/cj.a2013.0111

Cited by 16 publications

(14 citation statements)

References 21 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Contrary to the previously published data, in our study, a single lead was not sufficient to reliably distinguish between different sites of RV . Actually, based on the present data and our previous research limb lead I was useful to identify RVOT but was constantly positive in all RV locations . Three standard ECG leads were sufficient to identify proximal IVS but an additional lead was needed for reliable differentiation of the other RV regions.…”

Section: Discussioncontrasting

confidence: 99%

“…Because in previous papers the definition of the term “septal pacing” was mostly attributed to the RVOT septum, in our study we separated the RVOT from the high right ventricular septal region. Very similar definitions of PL positions are present in the paper by Nakamura et al The high right ventricular septal region was defined as the para‐Hisian area and contrary to the previous data no q wave (negative QRS complex) in lead I was observed . A negative QRS deflection on the basis of our and other researchers’ analyses can be seen at the anterior portion of RVOT .…”

Section: Discussionsupporting

confidence: 80%

“…Very similar definitions of PL positions are present in the paper by Nakamura et al The high right ventricular septal region was defined as the para‐Hisian area and contrary to the previous data no q wave (negative QRS complex) in lead I was observed . A negative QRS deflection on the basis of our and other researchers’ analyses can be seen at the anterior portion of RVOT . Contrary to the anterior part of RVOT which is characterized by negative pQRS complex in lead I the proximal septal—the para‐Hisian region is characterized by positive pQRS complexes in limb lead I …”

Section: Discussionsupporting

confidence: 75%

See 2 more Smart Citations

A novel ECG‐based algorithm to determine right ventricular lead placement in permanent pacemaker patients (RVpace study)

Zając

Farkowski

Kowalik

et al. 2019

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Introduction Fluoroscopy guidance alone is not sufficient for the accurate localization of the pacing lead (PL) in the right ventricle (RV) during implantation of the cardiac implantable electronic device (CIED). The aim of this study was to create a surface electrocardiogram (ECG) algorithm based on paced QRS (pQRS) morphology to accurately localize PL position in the RV. Methods and Results Thirty consecutive patients scheduled for catheter ablation of right heart arrhythmias were enrolled. After the elimination of index arrhythmia pacing from the RV interventricular septum (IVS), apex and free wall was performed and pQRS were recorded. The pacing site was verified both by fluoroscopy and transthoracic echocardiography. After a careful analysis of pQRS, a stepwise algorithm was developed to aid the proper positioning of the PL in RV. The algorithm was later prospectively validated in 31 pacemaker patients undergoing an elective generator exchange. A clear R wave in I, II, and V5 leads indicated proximal IVS. For a reliable indication of other RV sites, four ECG leads were crucial I, II, V5, and V6. A prospective evaluation of the algorithm revealed 90.3% agreement between RV lead localization obtained by ECG and echocardiography, with sensitivity of 92.5% (95% confidence interval [CI], 83.2%‐100.0%) and a positive predictive value of 96.0% (95% CI, 89.0%‐100.0%) for desired lead locations in RV. Conclusion A simple ECG algorithm can reliably differentiate between the sites of permanent PL implantation in the RV in CIED recipients.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

A novel ECG‐based algorithm to determine right ventricular lead placement in permanent pacemaker patients (RVpace study)

Zając

Farkowski

Kowalik

et al. 2019

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…The ECG obtained during VT provides essential information about the region of origin of the arrhythmia [41]. Importantly, surface ECG from a reentrant VT tends to locate the exit site of the circuit, rather than the circuit in which it is generated.…”

Section: Location Of the Origin Of Ventricular Tachycardiamentioning

confidence: 99%

Sustained ventricular tachycardia in structural heart disease

Hadid

2015

Cardiol J

View full text Add to dashboard Cite

show abstract

“…The original article by Pytkowski et al [5] presented the highest impact on the topic of arrhythmias with a novel algorithm for focus localization in patients with right ventricular outflow tract arrhythmias, a useful observation to obtain better results with radiofrequency ablation.…”

mentioning

confidence: 99%