Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
State Key Lab of Modern Optical Instrumentation, Zhejiang University, Hangzhou, China.
J Int Med Res. 2020 Mar;48(3):300060520913132. doi: 10.1177/0300060520913132.
The aim of this study was to investigate the accuracy of electrocardiographic imaging (ECGI) in localizing the origin of outflow tract ventricular arrhythmias (OTVAs) and compare its performance with that of seven published 12-lead electrocardiography (ECG) algorithms.
Patients with OTVAs who were undergoing catheter ablation were prospectively investigated. The OVTA origins were localized using both ECGI and seven 12-lead ECG algorithms, with the successful ablation site set as the gold standard. The performance of the ECGI and 12-lead ECG algorithms were compared.
Twenty-seven patients were enrolled into the study. The ECGI system correctly identified the chamber of OTVA origin in 27/27 (100%) patients and the sublocalization within the right ventricular outflow tract (RVOT) in 21/22 (95.5%) patients. However, the ECG algorithms correctly diagnosed the chamber and sublocalization in only 21/27 (77.8%) patients and 13/22 (59.1%) patients, respectively, which was significantly lower compared with the ECGI system.
Non-invasive ECGI can accurately predict the origin of OTVAs in a manner that is superior to that of conventional 12-lead ECGs in differentiating the RVOT from the left ventricular outflow tract (LVOT) and septum from free wall in the RVOT. This provides a useful tool to guide catheter ablation. This trial has been registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR1900025527).
本研究旨在探讨心电图影像（ECGI）在定位流出道室性心律失常（OTVA）起源中的准确性，并与 7 种已发表的 12 导联心电图（ECG）算法进行比较。
前瞻性研究了接受导管消融的 OTVA 患者。使用 ECGI 和 7 种 12 导联 ECG 算法定位 OVTA 起源，以成功消融部位作为金标准。比较了 ECGI 和 12 导联 ECG 算法的性能。
共纳入 27 例患者。ECGI 系统正确识别了 27/27（100%）患者的 OTVA 起源室和 21/22（95.5%）患者的右心室流出道（RVOT）亚部位。然而，ECG 算法仅正确诊断了 21/27（77.8%）患者的起源室和 13/22（59.1%）患者的 RVOT 亚部位，明显低于 ECGI 系统。
非侵入性 ECGI 可以准确预测 OTVA 的起源，在区分 RVOT 与左心室流出道（LVOT）以及 RVOT 中的间隔与游离壁方面，优于传统的 12 导联 ECG。这为导管消融提供了一种有用的工具。本试验已在中国临床试验注册中心（注册号：ChiCTR1900025527）注册。
