RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study
Background This study aimed to investigate the predictive value of parameters of every precordial lead and their combinations in differentiating between idiopathic ventricular arrhythmias (IVAs) from the right ventricular outflow tract and aortic sinus of Valsalva (ASV). Methods and Results Between...
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| Format: | Article |
| Language: | English |
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Wiley
2024-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033779 |
| _version_ | 1797229248735346688 |
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| author | Ning Chen Lei Wang Jincheng Jiao Weizhu Ju Zhe Wang Cao Zou Fu Yi Fangyi Xiao Wenzhi Shen Chengzong Li Linsheng Shi Long Chen Yuan Ji Youquan Wei Kai Gu Gang Yang Hongwu Chen Mingfang Li Hailei Liu Minglong Chen |
| author_facet | Ning Chen Lei Wang Jincheng Jiao Weizhu Ju Zhe Wang Cao Zou Fu Yi Fangyi Xiao Wenzhi Shen Chengzong Li Linsheng Shi Long Chen Yuan Ji Youquan Wei Kai Gu Gang Yang Hongwu Chen Mingfang Li Hailei Liu Minglong Chen |
| author_sort | Ning Chen |
| collection | DOAJ |
| description | Background This study aimed to investigate the predictive value of parameters of every precordial lead and their combinations in differentiating between idiopathic ventricular arrhythmias (IVAs) from the right ventricular outflow tract and aortic sinus of Valsalva (ASV). Methods and Results Between March 1, 2018, and December 1, 2021, consecutive patients receiving successful ablation of right ventricular outflow tract or ASV IVAs were enrolled. The amplitude and duration of the R wave and S wave were measured in every precordial lead during IVAs. These parameters were either summed, subtracted, multiplied, or divided to create different indexes. The index with the highest area under the curve to predict ASV IVAs was developed, compared with established indexes, and validated in an independent prospective multicenter cohort. A total of 150 patients (60 men; mean age, 45.3±16.4 years) were included in the derivation cohort. The RV1+RV3 index (summed R‐wave amplitude in leads V1 and V3) had the highest area under the curve (0.942) among the established indexes. An RV1+RV3 index >1.3 mV could predict ASV IVAs with a sensitivity of 95% and a specificity of 83%. Its predictive performance was maintained in the validation cohort (N=109). In patients with V3 R/S transition, an RV1+RV3 index >1.3 mV could predict ASV IVAs, with an area under the curve of 0.892, 93% sensitivity, and 75% specificity. Conclusions The RV1+RV3 index is a simple and novel criterion that accurately differentiates between right ventricular outflow tract and ASV IVAs. Its performance outperformed established indexes, making it a valuable tool in clinical practice. |
| first_indexed | 2024-04-24T15:09:35Z |
| format | Article |
| id | doaj.art-6c6e02df979244adb7fc2b4536a2b39b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:09:35Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-6c6e02df979244adb7fc2b4536a2b39b2024-04-02T11:49:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-04-0113710.1161/JAHA.123.033779RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter StudyNing Chen0Lei Wang1Jincheng Jiao2Weizhu Ju3Zhe Wang4Cao Zou5Fu Yi6Fangyi Xiao7Wenzhi Shen8Chengzong Li9Linsheng Shi10Long Chen11Yuan Ji12Youquan Wei13Kai Gu14Gang Yang15Hongwu Chen16Mingfang Li17Hailei Liu18Minglong Chen19The First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Soochow University Soochow ChinaXijing Hospital Xi’an ChinaThe First Affiliated Hospital of Wenzhou Medical University Wenzhou ChinaNanjing Drum Tower Hospital Nanjing ChinaThe Affiliated Hospital of Xuzhou Medical University Xuzhou ChinaThe Second Affiliated Hospital of Nantong University Nantong ChinaZhongda Hospital Nanjing ChinaChangzhou No.2 People’s Hospital Changzhou ChinaThe First Affiliated Yijishan Hospital of Wannan Medical College Wuhu ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaThe First Affiliated Hospital of Nanjing Medical University Nanjing ChinaBackground This study aimed to investigate the predictive value of parameters of every precordial lead and their combinations in differentiating between idiopathic ventricular arrhythmias (IVAs) from the right ventricular outflow tract and aortic sinus of Valsalva (ASV). Methods and Results Between March 1, 2018, and December 1, 2021, consecutive patients receiving successful ablation of right ventricular outflow tract or ASV IVAs were enrolled. The amplitude and duration of the R wave and S wave were measured in every precordial lead during IVAs. These parameters were either summed, subtracted, multiplied, or divided to create different indexes. The index with the highest area under the curve to predict ASV IVAs was developed, compared with established indexes, and validated in an independent prospective multicenter cohort. A total of 150 patients (60 men; mean age, 45.3±16.4 years) were included in the derivation cohort. The RV1+RV3 index (summed R‐wave amplitude in leads V1 and V3) had the highest area under the curve (0.942) among the established indexes. An RV1+RV3 index >1.3 mV could predict ASV IVAs with a sensitivity of 95% and a specificity of 83%. Its predictive performance was maintained in the validation cohort (N=109). In patients with V3 R/S transition, an RV1+RV3 index >1.3 mV could predict ASV IVAs, with an area under the curve of 0.892, 93% sensitivity, and 75% specificity. Conclusions The RV1+RV3 index is a simple and novel criterion that accurately differentiates between right ventricular outflow tract and ASV IVAs. Its performance outperformed established indexes, making it a valuable tool in clinical practice.https://www.ahajournals.org/doi/10.1161/JAHA.123.033779aortic sinus of ValsalvaECGidiopathic ventricular arrhythmiaright ventricular outflow tract |
| spellingShingle | Ning Chen Lei Wang Jincheng Jiao Weizhu Ju Zhe Wang Cao Zou Fu Yi Fangyi Xiao Wenzhi Shen Chengzong Li Linsheng Shi Long Chen Yuan Ji Youquan Wei Kai Gu Gang Yang Hongwu Chen Mingfang Li Hailei Liu Minglong Chen RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic sinus of Valsalva ECG idiopathic ventricular arrhythmia right ventricular outflow tract |
| title | RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study |
| title_full | RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study |
| title_fullStr | RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study |
| title_full_unstemmed | RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study |
| title_short | RV1+RV3 Index to Differentiate Idiopathic Ventricular Arrhythmias Arising From Right Ventricular Outflow Tract and Aortic Sinus of Valsalva: A Multicenter Study |
| title_sort | rv1 rv3 index to differentiate idiopathic ventricular arrhythmias arising from right ventricular outflow tract and aortic sinus of valsalva a multicenter study |
| topic | aortic sinus of Valsalva ECG idiopathic ventricular arrhythmia right ventricular outflow tract |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033779 |
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