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Assessment of a single monomorphic ventricular ectopy from the right ventricular outflow tract in standard and high resolution electrocardiogram.

Kozłowski D, Kosiński A, Dąbrowska-Kugacka A, Lewicka-Nowak E, Dudziak M, Grzybiak M, Raczak G - Arch Med Sci (2010)

Bottom Line: The point of origin of VPCs was compared in both methods.However, we did not affirm their presence in points 2,4,6.Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland.

ABSTRACT

Introduction: High-resolution electrocardiography (ECG-CREM) is a method based on digital electrocardiography. In order to facilitate the interpretation of the Crem records the technique of vectorcardiography was used. In comparison the origin of the ventricular premature complexes (VPCs) could be estimated based on a standard 12-lead electrocardiogram. The aim of the study was to assess the point of origin of the VPCs in ECG-CREM and correlate it with standard electrocardiography (ECG-Stand).

Material and methods: Our study included 26 patients (16 females, 10 males), aged 51-83 years (avg. 58.1 ±12.3), who presented with recurrent, during at least 6 months' observation, VPCs. The point of origin of VPCs was compared in both methods.

Results: The performed analysis of collected ECG-Stand records revealed the presence of arrhythmogenic focal points in six different locations (1, 3, 5, 7, 8, 9). However, we did not affirm their presence in points 2,4,6. They were most commonly located in RVOT zones 8 (30.7%), 9 (23.0%), 5 (23.0%), and most seldom in zones 1, 3, 7 (7.6% each). In the simultaneous record of ECG-CREM with a single VPC it was confirmed that the FPb zone was activated the most frequently (40.0%); the next in relation to frequency were SD and ST (20.0%). Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%).

Conclusions: Electrocardiogram of high signal resolution (ECG-CREM) might be useful in recognition of the origin of ventricular premature complexes from RVOT.

No MeSH data available.


Related in: MedlinePlus

Location of trigger zone on ECG-Stand and ECG-CREM in patient W.L., ♂, 22-year-old. A – 12-lead ECG is presented with the origin of VPCs from region number 5. B – ECG-CREM is presented with the origin of VPCs from zone FPb and SB
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Figure 1: Location of trigger zone on ECG-Stand and ECG-CREM in patient W.L., ♂, 22-year-old. A – 12-lead ECG is presented with the origin of VPCs from region number 5. B – ECG-CREM is presented with the origin of VPCs from zone FPb and SB

Mentions: Based on our study in position number 1 (superior-posterior region) arrhythmia occurred in 2 patients (ECG-Stand: I – R + aVL – QS + V3-yes) – 7.6%. In position number 3 (superior-anterior region) VPCs appeared in 2 patients (ECG-Stand: I – QS + aVL - QS + V3-yes) – 7.6%. In position number 5 (central-intermediate region) arrhythmia occurred in 6 patients (ECG-Stand: I – Rs + aVL – qS + V3-no) – 23.0%. In Figure 1A, the 12-lead ECG is presented with the origin of VPCs from region number 5 (♂, 22-year-old). In position number 7 (inferior-posterior region) VPCs were confirmed in 2 patients (ECG-Stand: I – RS + aVL – Rs + V3-yes) – 7.6%. In position number 8 (inferior-intermediate region) ECG was characterized by I – R + aVL – R + V3-no and it appeared in 8 patients (30.7%). Meanwhile, in position number 9 (inferior-anterior region) ECG had the features: I – QS / QR + aVL – QS + V3-no and such a record was observed in 6 cases (23.0%). We were not able to find any correlation between the position of the trigger zone and patients’ sex or age. The ECG-CREM was executed twice: the first during normal sinus rhythm and the second during spontaneous ventricular extrasystoles. Unfortunately, only 15 of 26 records were completed and enabled further processing and assessment. The result analysis during sinus rhythm without VPCs revealed the highest values of electrical activity, normalized as well as standardized, in the inferior wall zone (SD). Electrical activity ranged in this zone from 15 mV2 to 309 mV2 (average 160.4 ±74.8 mV2). The next part of the heart muscle with high electric activity was the posterior wall zone (ST). The mean value of relative electrical activity was 60.2 ±39.8 mV2 (range: 8 to 108 mV2). The next highest zone with high electrical activity was the posterior-inferior-lateral zone (LOT) with a range of values from 3 to 106 mV2 and average 32.6 ±41.7 mV2. The mean value of electrical activity, normalized as well as standardized, was lowest in the anterior-septal zone (PPG) and highest in the posterior zone (ST). The difference between those two zones was statistically non-significant (p > 0.05). Data are shown in Table I.


Assessment of a single monomorphic ventricular ectopy from the right ventricular outflow tract in standard and high resolution electrocardiogram.

Kozłowski D, Kosiński A, Dąbrowska-Kugacka A, Lewicka-Nowak E, Dudziak M, Grzybiak M, Raczak G - Arch Med Sci (2010)

Location of trigger zone on ECG-Stand and ECG-CREM in patient W.L., ♂, 22-year-old. A – 12-lead ECG is presented with the origin of VPCs from region number 5. B – ECG-CREM is presented with the origin of VPCs from zone FPb and SB
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298340&req=5

Figure 1: Location of trigger zone on ECG-Stand and ECG-CREM in patient W.L., ♂, 22-year-old. A – 12-lead ECG is presented with the origin of VPCs from region number 5. B – ECG-CREM is presented with the origin of VPCs from zone FPb and SB
Mentions: Based on our study in position number 1 (superior-posterior region) arrhythmia occurred in 2 patients (ECG-Stand: I – R + aVL – QS + V3-yes) – 7.6%. In position number 3 (superior-anterior region) VPCs appeared in 2 patients (ECG-Stand: I – QS + aVL - QS + V3-yes) – 7.6%. In position number 5 (central-intermediate region) arrhythmia occurred in 6 patients (ECG-Stand: I – Rs + aVL – qS + V3-no) – 23.0%. In Figure 1A, the 12-lead ECG is presented with the origin of VPCs from region number 5 (♂, 22-year-old). In position number 7 (inferior-posterior region) VPCs were confirmed in 2 patients (ECG-Stand: I – RS + aVL – Rs + V3-yes) – 7.6%. In position number 8 (inferior-intermediate region) ECG was characterized by I – R + aVL – R + V3-no and it appeared in 8 patients (30.7%). Meanwhile, in position number 9 (inferior-anterior region) ECG had the features: I – QS / QR + aVL – QS + V3-no and such a record was observed in 6 cases (23.0%). We were not able to find any correlation between the position of the trigger zone and patients’ sex or age. The ECG-CREM was executed twice: the first during normal sinus rhythm and the second during spontaneous ventricular extrasystoles. Unfortunately, only 15 of 26 records were completed and enabled further processing and assessment. The result analysis during sinus rhythm without VPCs revealed the highest values of electrical activity, normalized as well as standardized, in the inferior wall zone (SD). Electrical activity ranged in this zone from 15 mV2 to 309 mV2 (average 160.4 ±74.8 mV2). The next part of the heart muscle with high electric activity was the posterior wall zone (ST). The mean value of relative electrical activity was 60.2 ±39.8 mV2 (range: 8 to 108 mV2). The next highest zone with high electrical activity was the posterior-inferior-lateral zone (LOT) with a range of values from 3 to 106 mV2 and average 32.6 ±41.7 mV2. The mean value of electrical activity, normalized as well as standardized, was lowest in the anterior-septal zone (PPG) and highest in the posterior zone (ST). The difference between those two zones was statistically non-significant (p > 0.05). Data are shown in Table I.

Bottom Line: The point of origin of VPCs was compared in both methods.However, we did not affirm their presence in points 2,4,6.Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%).

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland.

ABSTRACT

Introduction: High-resolution electrocardiography (ECG-CREM) is a method based on digital electrocardiography. In order to facilitate the interpretation of the Crem records the technique of vectorcardiography was used. In comparison the origin of the ventricular premature complexes (VPCs) could be estimated based on a standard 12-lead electrocardiogram. The aim of the study was to assess the point of origin of the VPCs in ECG-CREM and correlate it with standard electrocardiography (ECG-Stand).

Material and methods: Our study included 26 patients (16 females, 10 males), aged 51-83 years (avg. 58.1 ±12.3), who presented with recurrent, during at least 6 months' observation, VPCs. The point of origin of VPCs was compared in both methods.

Results: The performed analysis of collected ECG-Stand records revealed the presence of arrhythmogenic focal points in six different locations (1, 3, 5, 7, 8, 9). However, we did not affirm their presence in points 2,4,6. They were most commonly located in RVOT zones 8 (30.7%), 9 (23.0%), 5 (23.0%), and most seldom in zones 1, 3, 7 (7.6% each). In the simultaneous record of ECG-CREM with a single VPC it was confirmed that the FPb zone was activated the most frequently (40.0%); the next in relation to frequency were SD and ST (20.0%). Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%).

Conclusions: Electrocardiogram of high signal resolution (ECG-CREM) might be useful in recognition of the origin of ventricular premature complexes from RVOT.

No MeSH data available.


Related in: MedlinePlus