Background
Methods
Study population
Electrocardiographic analysis
Electrophysiological study and RFCA
Definition of success
Follow-up
Ethnics of the study
Results
Basic clinical characteristics of studied population
Basic Clinic Data | Total (n = 106) | MSPA (n = 31) | PSCs (n = 75) | P value |
---|---|---|---|---|
Age (Y) | 45.99 ± 13.66 | 44.51 ± 13.61 | 46.60 ± 13.29 | > 0.05 |
Sex (Male) | 32 | 10 (32.25) | 22 (30.14) | > 0.05 |
Smoking | 11 | 3 (9.68) | 8 (10.95) | > 0.05 |
Hypertension | 11 | 3 (9.68) | 8 (10.95) | > 0.05 |
Diabetes | 9 | 3 (9.68) | 6 (8.22) | > 0.05 |
Arrhythmias (PVCs) | 89 | 26 (83.87) | 63 (84.00) | > 0.05 |
LVEDD (mm) | 44.20 ± 7.05 | 46.08 ± 7.81 | 43.43 ± 6.61 | > 0.05 |
LVEF (%) | 62.37 ± 6.57 | 61.45 ± 7.15 | 62.76 ± 6.33 | > 0.05 |
Counts/24 h | 21,318.00 ± 7262.01 | 24,602.52 ± 7833.80 | 19,960.46 ± 6600.23 | > 0.05 |
Disease course (Y) | 3.15 ± 1.07 | 3.04 ± 1.07 | 3.19 ± 1.08 | > 0.05 |
Electrophysiological study and radiofrequency ablation
Total (n = 106) | MSPA (n = 31) | PSCs (n = 75) | P valve | |
---|---|---|---|---|
Pulmonary artery potential | 18 (17.0%) | 4 (12.9%) | 14 (18.7%) | > 0.05 |
QS morphology in unipolar electrogram | 106 (100%) | 31 (100%) | 75 (100%) | > 0.05 |
With notch in descending limb | 41 (38.7%) | 11 (35.5%) | 30 (40%) | > 0.05 |
Farfield atrial potential of target site in bipolar electrogram | 63 (59.4%) | 18 (58.1%) | 45 (60.0%) | > 0.05 |
Merged or discrete potential of peak or split morphology of target site in bipolar electrogram | 69 (65.1%) | 20 (64.5%) | 49 (65.3%) | > 0.05 |
Reversed polarity of bipolar electrograms | 53 (50.0%) | 15 (48.4%) | 38 (50.7%) | > 0.05 |
Application of temperature-controlled catheter | 34 (32.1%) | 26 (83.87) | 9 (13.0) | < 0.001 |
Application of irrigated-tip catheter | 71 (67.0%) | 5 (16.13) | 66 (87.00) | < 0.05 |
V-QRS (ms) | −34.71 ± 4.26 | −35.62 ± 6.79 | −34.78 ± 3.75 | > 0.05 |
Pace match of target site (lead) | 11.16 ± 0.90 | 11.34 ± 0.52 | 11.08 ± 0.90 | < 0.05 |
Pacing target site induced good pace match | 95 (89.6%) | 25 (80.7%) | 70 (93.3%) | > 0.05 |
12-lead match | 40 (37.7%) | 10 (32.3%) | 30 (40.0%) | > 0.05 |
11-lead match | 33 (31.1%) | 9 (29.0%) | 24 (32.0%) | > 0.05 |
10-lead match | 22 (20.8%) | 6 (19.4%) | 16 (21.3%) | > 0.05 |
Application of R0 Swartz sheath | 73 (68.9%) | 2 (6.45%) | 71 (94.67) | < 0.001 |
Procedural time (min) | 54.28 ± 13.63 | 65.24 ± 17.26 | 46.28 ± 9.30 | < 0.001 |
Fluoroscopic time (min) | 8.07 ± 2.93 | 9.31 ± 3.16 | 7.19 ± 2.77 | < 0.05 |
Lesions of energy application | 2.76 ± 1.89 | 3.89 ± 2.59 | 2.20 ± 0.79 | < 0.001 |
Energy delivery duration (s) | 243.86 ± 88.40 | 335.32 ± 72.11 | 210.76 ± 65.80 | < 0.001 |
Success of ablation | 106 (100%) | 31 (100.00) | 75 (100.00) | > 0.05 |
Response of energy application on target site | ||||
PVC/VT disappeared immediately | 95 (89.6%) | 27 (87.10) | 68 (90.67) | > 0.05 |
PVC accelerated or decelerated prior to disappearance | 11 (10.4%) | 4 (12.90) | 7 (10.72) | > 0.05 |
ECG characteristics of the VAs arising from the region above the pulmonary artery
Origin | MPSA (n = 31) | PSCs (n = 75) |
P
|
---|---|---|---|
RII (mV) | 2.32 ± 0.52 | 1.81 ± 0.58 | < 0.05 |
RIII (mV) | 2.36 ± 0.65 | 1.69 ± 0.55 | < 0.05 |
RaVF (mV) | 2.34 ± 0.58 | 1.74 ± 0.56 | < 0.05 |
RII+ RIII+ RaVF (mV) | 6.76 ± 1.38 | 4.62 ± 1.04 | < 0.05 |
V1 R/S | 0.21 ± 0.07 | 0.28 ± 0.05 | > 0.05 |
V2 R/S | 0.31 ± 0.12 | 0.35 ± 0.07 | > 0.05 |
Precordial transition zone | |||
< V3 | 7 (22.58%) | 15 (20.00%) | > 0.05 |
= V3 | 15 (48.39%) | 36 (48.00%) | > 0.05 |
> V3 | 9 (29.03%) | 24 (32.00%) | > 0.05 |
Precordial transition index | |||
> 0 | 12 (38.71%) | 26 (34.67%) | > 0.05 |
= 0 | 16 (51.61%) | 40 (53.33%) | > 0.05 |
< 0 | 3 (9.67%) | 9 (12.00%) | > 0.05 |
Anterior PSC and corresponding MSPA (PAC-AMSPA, 38cases) | Left PSC and corresponding MSPA (PLC-LMSPA, 50 cases) | Right PSC and corresponding MSPA (PRC-RMSPA, 18 cases) | |
---|---|---|---|
Lead I | QS、qs、rs、qr. or r pattern | rs or r pattern | R pattern |
Lead II, III and aVF | R pattern, ascending limb notch or peak notch may be seen | R pattern, ascending limb notch or peak notch may be seen | R pattern, descending limb notch may be seen |
Lead aVR and a VL | QS, QSaVL>QSaVR | QS, QSaVR>QSaVL | main QS, a minority of qs or qR, QSaVR>QSaVl |
Lead V1-V2 | rS or RS | rS or RS | rS or RS |
Lead V3 | rS, RS or Rs | rS, RS or Rs | rS |
Lead V4 | R or Rs | R or Rs | Rs or R |
Lead V5-V6 | R pattern, ascending limb notch or peak notch may be seen | R pattern, ascending limb notch or peak notch may be seen | R pattern, descending limb notch may be seen |
R I (mV) | −0.12 ± 0.11#^ | 0.36 ± 0.13 | 0.41 ± 0.18 |
RII (mV) | 1.92 ± 0.48 | 1.83 ± 0.38 | 1.45 ± 0.41*# |
RIII (mV) | 2.04 ± 0.49#^ | 1.52 ± 0.42*^ | 1.11 ± 0.39*# |
RaVF (mV) | 1.96 ± 0.47#^ | 1.67 ± 0.39*^ | 1.27 ± 0.41*# |
RII + III + aVF (mV) | 6.02 ± 1.45#^ | 5.13 ± 1.32*^ | 3.94 ± 1.01*# |
QSaVR (mV) | −0.96 ± 0.22 | −1.05 ± 0.36 | − 0.92 ± 0.39 |
QSaVL (mV) | −1.07 ± 0.26#^ | −0.61 ± 0.32*^ | − 0.33 ± 0.28*# |
QSaVR/aVL | 0.89 ± 0.23#^ | 1.72 ± 1.32*^ | 2.79 ± 2.57*# |
RV1(mV) | 0.28 ± 0.13 | 0.32 ± 0.12 | 0.36 ± 0.22 |
RV2(mV) | 0.35 ± 0.17 | 0.55 ± 0.22*^ | 0.42 ± 0.24 |
RV3(mV) | 0.63 ± 0.31 | 0.89 ± 0.37*^ | 0.66 ± 0.33 |
RV4(mV) | 1.28 ± 0.52 | 1.39 ± 0.51 | 0.99 ± 0.41*# |
RV5(mV) | 1.79 ± 0.53 | 1.68 ± 0.51 | 1.38 ± 0.54*# |
RV6(mV) | 1.72 ± 0.43 | 1.67 ± 0.53 | 1.36 ± 0.49*# |
RV4 + V5 + V6(mV) | 4.79 ± 1.32 | 4.74 ± 1.68 | 3.73 ± 0.82*# |