Electrocardiogram and cardiac electrophysiology characteristics of the premature ventricular contractions originating from right ventricular outflow tract

Xuan Tuan Nguyen1,, The Nam Huy Nguyen1, Thanh Nam Phan1, Sinh Huy Nguyen
1 Hanoi Heart Hospital

Main Article Content

Abstract

Premature ventricular contractions (PVCs) are a common type of irregular heartbeat (arrhythmia). PVCs often cause of symptoms that reduced quality of life such as: palpitation, pounding or jumping, chest pain, fatigue, blank beats or missed beats… Besides that, PVCs can produce ventricular tachycardia, which can lead to life-threatening hemodynamic instability.[1]


Research objectives: Evalute the electrocardiogram and electrophysiology charaterics of the PVCs from right ventricular outflow tract. 


Objects and research methods: Cross-sectional descriptive study of 145 patients.


Research results: all patients had R waveform in: D2, D3, aVF and S wave dominant in: aVR, aVL; Transitional lead from V3-V5, in which transition in V4 accounts for the highest rate of 60.7%. The average QRS time is 136.3 ± 14.4 ms, almost all PVCs have time index of R < 0.5 and amplitude index of R < 0.3… There are 48.3% of patients with only negative component in lead D1; 40% of PVCs have notching at D2, D3, aVF. About cardiac electrophysiolpgy charateristics, for the origin of PVCs, he majority of PVCs in our study originated from the anterior wall of the right ventricular outflow tract with 64.8%; by superior-inferior  position, mainly inferior region with 66.9%; according to septum - lateral position, mainly septal region with 72.4%. Most patients had PVCs originated from the inferior-anterior-septal region of the right ventricular outflow tract with 36.6%.

Article Details

References

1. Nguyễn Hồng Hạnh (2010). Nghiên cứu ứng dụng điện sinh học tim để chẩn đoán và điều trị một số rối loạn nhịp thất bằng năng lượng sóng có tần số radio. Học viện Quân Y. Số Luận án tiến sĩ Y học.
2. Phạm Trường Sơn (2020). Vai trò điện tim bề mặt trong đánh giá vị trí ngoại tâm thu thất nguyên phát xuất phát từ đường ra thất phải. Tạp chí Y dược Lâm sàng 108. Số 15.(5), Tr.1–7
3. Trương Quang Khanh (2013). Nghiên cứu kết quả điều trị nhịp nhanh thất nguyên phát bằng năng lượng sóng tần số Radio qua Catheter. Đại học Y Hà Nội. Số Luận Án Tiến sĩ Y học.
4. Vũ Mạnh Tân (2017). Nghiên cứu điện tâm đồ bề mặt để định hướng vị trí khởi phát của ngoại tâm thu thất/ nhịp nhan thất ở đường ra thất phải. Tạp chí Y học Việt Nam. Số 460.(11), Tr.273–8
5. Anderson RD, Kumar S, Parameswaran R, Wong G, Voskoboinik A, Sugumar H, et al. (2019). Differentiating Right- and Left-Sided Outflow Tract Ventricular Arrhythmias: Classical ECG Signatures and Prediction Algorithms. Circ Arrhythm Electrophysiol. Số 12.(6), Tr.e007392
6. Anderson RD, Kumar S, Parameswaran R, Wong G, Voskoboinik A, Sugumar H, et al. (2019). Differentiating Right- and Left-Sided Outflow Tract Ventricular Arrhythmias: Classical ECG Signatures and Prediction Algorithms. Circ Arrhythm Electrophysiol. Số 12.(6), Tr.e007392
7. Simpson RJ, Cascio WE, Schreiner PJ, Crow RS, Rautaharju PM, Heiss G (2002). Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. Số 143.(3), Tr.535–40
8. Cheng Z, Cheng K, Deng H, Chen T, Gao P, Zhu K, et al. (2013). The R-wave deflection interval in lead V3 combining with R-wave amplitude index in lead V1: a new surface ECG algorithm for distinguishing left from right ventricular outflow tract tachycardia origin in patients with transitional lead at V3. Int J Cardiol. Số 168.(2), Tr.1342–8
9. Farzam K, Richards JR (2023). Premature Ventricular Contraction. StatPearls. StatPearls Publishing, Treasure Island (FL).
10. Lian-Pin W, Yue-Chun L, Jing-Lin Z, Cheng Z, Jun-Hua C, Jun H, et al. (2013). Catheter ablation of idiopathic premature ventricular contractions and ventricular tachycardias originating from right ventricular septum. PLoS One. Số 8.(6), Tr.e67038.