The transition zone in precordial electrocardiograms from multiple sites

Rosenman, Ray H.; Reynolds, Ralph W.

doi:10.1016/0002-8703(50)90183-9

American Heart Journal

1950

DOI: 10.1016/0002-8703(50)90183-9

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The transition zone in precordial electrocardiograms from multiple sites

Ray H. Rosenman

Ralph W. Reynolds

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Cited by 2 publications

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“…The early precordial pattern break was defined as a pattern break occurring at lead V2 and the transition zone was defined as the lead in which the QRS complex changed from predominantly negative to positive in which the R ≥ S wave in amplitude. 7,8 The MDI was calculated as the ratio between the time to maximum deflection and QRS duration. The time to maximum deflection was defined as the interval between the onset to the peak of QRS in each precordial lead.…”

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Electrocardiographic localization of ventricular arrhythmias successfully ablated from the distal great cardiac vein

Chang

Gabriels

Vaishnav

et al. 2020

Cardiovasc electrophysiol

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Background: Idiopathic ventricular arrhythmias (IVAs) from the left ventricular (LV) summit may be successfully ablated from the distal great cardiac vein (dGCV). Using a 12-lead electrocardiogram (ECG) to localize IVAs that can be ablated from the dGCV is valuable for ablation planning. Objective: To determine if a "w" wave, a notch in the Q wave in lead I, and other ECG features can identify IVAs that can be successfully ablated from the dGCV. Methods: We reviewed outflow tract premature ventricular contraction (PVC) ablations performed at two centers between September 2010 and June 2018. Successful PVC ablations, in which the PVCs were mapped from the right ventricular outflow tract, coronary cusps, commissures, endocardial LV, and the coronary venous system including the dGCV were included. ECG characteristics were compared between patients with successful ablations in the dGCV and non-dGCV sites. Results: Of the 120 patients (age 56.8 ± 13.8 years, 45% female) that met the inclusion criteria, the dGCV was the successful ablation site in 18 patients (15%). Multivariate analysis with binary logistic regression showed that a "w" in lead I in combination with an early precordial pattern break and a maximum deflection index (MDI) ≥ 0.5 had sensitivity and specificity for a successful ablation in the dGCV of 94.4% and 96.1%, respectively. Conclusion: Combining a "w" wave in lead I with an early precordial pattern break and an MDI ≥ 0.5 is highly sensitive and specific for identifying the dGCV as a successful ablation site for PVCs.

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confidence: 99%

Electrocardiographic localization of ventricular arrhythmias successfully ablated from the distal great cardiac vein

Chang

Gabriels

Vaishnav

et al. 2020

Cardiovasc electrophysiol

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The Lesser Electrocardiographic Signs of Cardiac Pain

Evans¹,

McRae²

1952

Heart

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The transition zone in precordial electrocardiograms from multiple sites

Cited by 2 publications

References 13 publications

Electrocardiographic localization of ventricular arrhythmias successfully ablated from the distal great cardiac vein

Electrocardiographic localization of ventricular arrhythmias successfully ablated from the distal great cardiac vein

The Lesser Electrocardiographic Signs of Cardiac Pain

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