A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy.
BACKGROUND:This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS:Seventy-one consecutive patients were enrolled and r...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5542590?pdf=render |
| _version_ | 1818924860965912576 |
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| author | Wan-Hsin Hsieh Chin-Yu Lin Abigail Louise D Te Men-Tzung Lo Cheng-I Wu Fa-Po Chung Yi-Chung Chang Shih-Lin Chang Chen Lin Li-Wei Lo Yu-Feng Hu Jo-Nan Liao Yun-Yu Chen Shih-Jie Jhuo Sunu Budhi Raharjo Yenn-Jiang Lin Shih-Ann Chen |
| author_facet | Wan-Hsin Hsieh Chin-Yu Lin Abigail Louise D Te Men-Tzung Lo Cheng-I Wu Fa-Po Chung Yi-Chung Chang Shih-Lin Chang Chen Lin Li-Wei Lo Yu-Feng Hu Jo-Nan Liao Yun-Yu Chen Shih-Jie Jhuo Sunu Budhi Raharjo Yenn-Jiang Lin Shih-Ann Chen |
| author_sort | Wan-Hsin Hsieh |
| collection | DOAJ |
| description | BACKGROUND:This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS:Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4). IQRSD was quantified by the angular difference between the reconstruction vectors obtained from the QRS-loop decomposition, based on a principal component analysis (PCA). Electroanatomic mapping and simulated ECGs were used to investigate the relationship between QRS dispersion and abnormal substrate. RESULTS:The percentage of the QRS loop area in the Group 1-2 was smaller than the controls (P = 0.01). The IQRSD between V1-V2 could differentiate all VTs from control (P<0.01). Group 1-2 had a greater IQRSD than the Group 3-4 (V4-V5,P = 0.001), and Group 1 had a greater IQRSD than Group 3-4 (V6-Lead I, P<0.001). Both real and simulated data had a positive correlation between the maximal IQRSD (γ = 0.62) and the extent of corresponding abnormal substrate (γ = 0.71, both P<0.001). CONCLUSIONS:The IQRSD of the surface ECG precordial leads successfully differentiated ARVC from controls, and could be used as a noninvasive marker to identify the abnormal substrate and the status of ARVC patients who can benefit from epicardial ablation. |
| first_indexed | 2024-12-20T02:32:03Z |
| format | Article |
| id | doaj.art-1506fcd66652465c856980bc1f22618f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T02:32:03Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj.art-1506fcd66652465c856980bc1f22618f2022-12-21T19:56:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018236410.1371/journal.pone.0182364A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy.Wan-Hsin HsiehChin-Yu LinAbigail Louise D TeMen-Tzung LoCheng-I WuFa-Po ChungYi-Chung ChangShih-Lin ChangChen LinLi-Wei LoYu-Feng HuJo-Nan LiaoYun-Yu ChenShih-Jie JhuoSunu Budhi RaharjoYenn-Jiang LinShih-Ann ChenBACKGROUND:This study investigated the feasibility of using the precordial surface ECG lead interlead QRS dispersion (IQRSD) in the identification of abnormal ventricular substrate in arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS:Seventy-one consecutive patients were enrolled and reclassified into 4 groups: definite ARVC with epicardial ablation (Group 1), ARVC with ventricular tachycardia (VT, Group 2), idiopathic right ventricular outflow tract VT without ARVC (Group 3), and controls without VT (Group 4). IQRSD was quantified by the angular difference between the reconstruction vectors obtained from the QRS-loop decomposition, based on a principal component analysis (PCA). Electroanatomic mapping and simulated ECGs were used to investigate the relationship between QRS dispersion and abnormal substrate. RESULTS:The percentage of the QRS loop area in the Group 1-2 was smaller than the controls (P = 0.01). The IQRSD between V1-V2 could differentiate all VTs from control (P<0.01). Group 1-2 had a greater IQRSD than the Group 3-4 (V4-V5,P = 0.001), and Group 1 had a greater IQRSD than Group 3-4 (V6-Lead I, P<0.001). Both real and simulated data had a positive correlation between the maximal IQRSD (γ = 0.62) and the extent of corresponding abnormal substrate (γ = 0.71, both P<0.001). CONCLUSIONS:The IQRSD of the surface ECG precordial leads successfully differentiated ARVC from controls, and could be used as a noninvasive marker to identify the abnormal substrate and the status of ARVC patients who can benefit from epicardial ablation.http://europepmc.org/articles/PMC5542590?pdf=render |
| spellingShingle | Wan-Hsin Hsieh Chin-Yu Lin Abigail Louise D Te Men-Tzung Lo Cheng-I Wu Fa-Po Chung Yi-Chung Chang Shih-Lin Chang Chen Lin Li-Wei Lo Yu-Feng Hu Jo-Nan Liao Yun-Yu Chen Shih-Jie Jhuo Sunu Budhi Raharjo Yenn-Jiang Lin Shih-Ann Chen A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. PLoS ONE |
| title | A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. |
| title_full | A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. |
| title_fullStr | A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. |
| title_full_unstemmed | A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. |
| title_short | A novel noninvasive surface ECG analysis using interlead QRS dispersion in arrhythmogenic right ventricular cardiomyopathy. |
| title_sort | novel noninvasive surface ecg analysis using interlead qrs dispersion in arrhythmogenic right ventricular cardiomyopathy |
| url | http://europepmc.org/articles/PMC5542590?pdf=render |
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