Noninvasive electrocardiographic mapping to guide ablation of outflow tract ventricular arrhythmias. Jamil-Copley, S., Bokan, R., Kojodjojo, P., Qureshi, N., Koa-Wing, M., Hayat, S., Kyriacou, A., Sandler, B., Sohaib, A., Wright, I., Davies, D., Whinnett, Z., Peters, N. S, Kanagaratnam, P., & Lim, P. Heart Rhythm, 11(4):587--594, Apr, 2014.
bibtex   
@Article{RSM:Jam2014,
  author =       "S. Jamil-Copley and R. Bokan and P. Kojodjojo and N.
                 Qureshi and M. Koa-Wing and S. Hayat and A. Kyriacou and
                 B. Sandler and A. Sohaib and I. Wright and D.W. Davies and
                 Z. Whinnett and N. S Peters and P. Kanagaratnam and P.B.
                 Lim",
  title =        "Noninvasive electrocardiographic mapping to guide
                 ablation of outflow tract ventricular arrhythmias.",
  journal =      "Heart Rhythm",
  year =         "2014",
  month =        "Apr",
  volume =       "11",
  number =       "4",
  pages =        "587--594",
  robnote =      "BACKGROUND: Localizing the origin of outflow tract
                 ventricular tachycardias (OTVT) is hindered by lack of
                 accuracy of electrocardiographic (ECG) algorithms and
                 infrequent spontaneous premature ventricular complexes
                 (PVCs) during electrophysiological studies. OBJECTIVES: To
                 prospectively assess the performance of noninvasive
                 electrocardiographic mapping (ECM) in the
                 pre-/periprocedural localization of OTVT origin to guide
                 ablation and to compare the accuracy of ECM with that of
                 published ECG algorithms. METHODS: Patients with
                 symptomatic OTVT/PVCs undergoing clinically indicated
                 ablation were recruited. The OTVT/PVC origin was mapped
                 preprocedurally by using ECM, and 3 published ECG
                 algorithms were applied to the 12-lead ECG by 3 blinded
                 electrophysiologists. Ablation was guided by using ECM.
                 The OTVT/PVC origin was defined as the site where ablation
                 caused arrhythmia suppression. Acute success was defined
                 as abolition of ectopy after ablation. Medium-term success
                 was defined as the abolition of symptoms and reduction of
                 PVC to less than 1000 per day documented on Holter
                 monitoring within 6 months. RESULTS: In 24 patients (mean
                 age 50 +/- 18 years) recruited ECM successfully identified
                 OTVT/PVC origin in 23/24 (96\%) (right ventricular outflow
                 tract, 18; left ventricular outflow tract, 6),
                 sublocalizing correctly in 100\% of this cohort. Acute
                 ablation success was achieved in 100\% of the cases with
                 medium-term success in 22 of 24 patients. PVC burden
                 reduced from 21,837 +/- 23,241 to 1143 +/- 4039 (P <
                 .0001). ECG algorithms identified the correct chamber of
                 origin in 50\%-88\% of the patients and sublocalized
                 within the right ventricular outflow tract (septum vs
                 free-wall) in 37\%-58\%. CONCLUSIONS: ECM can accurately
                 identify OTVT/PVC origin in the left and the right
                 ventricle pre- and periprocedurally to guide catheter
                 ablation with an accuracy superior to that of published
                 ECG algorithms.",
  bibdate =      "Mon May 11 22:36:21 2015",
  pmcid =        "PMC4067940",
}

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