Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy

Shinya Yamada, Fa Po Chung, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Tze Fan Chao, Jo Nan Liao, Chung-Hsing Lin, Chin Yu Lin, Yao Ting Chang, Abigail Louise D. Te, Ying Chieh Liao, Po Ching Chi, Shih Ann Chen

Research output: Contribution to journalArticle

Abstract

Purpose: In spite of several proposed predictors for premature ventricular complex (PVC)-induced cardiomyopathy (PVC-CMP), the specific ECG features of idiopathic right ventricular outflow tract (RVOT) PVC-CMP remain unknown. Methods: A total of 130 patients (49 males, mean age 44 years) with symptomatic and drug-refractory idiopathic RVOT PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. The patients were categorized into two groups, including those with and without RVOT PVC-CMP (left ventricular ejection fraction (LVEF) < 50%, n = 25 and LVEF ≥ 50%, n = 105, respectively). The 12-lead PVC morphologies were assessed. Results: Patients with RVOT PVC-CMP had a lower LVEF (42 ± 5% vs. 60 ± 7%, P < 0.01) and higher PVC burden (24 ± 14% vs. 15 ± 11%, P = 0.02) when compared to patients without RVOT PVC-CMP. The PVC features in those with PVC-CMP displayed a significantly wider QRS duration (143 ± 14 ms vs. 132 ± 17 ms, P < 0.01) and higher peak deflection index (PDI; 0.60 ± 0.07 vs. 0.55 ± 0.08, P < 0.01). A multivariate analysis demonstrated that the QRS duration (odds ratio (OR) 1.130, 95% confidence interval (CI) 1.020–1.253, P = 0.02) and PDI (OR 1.240, 95% CI 1.004–1.532, P = 0.04) were independently associated with RVOT PVC-CMP. Based on the receiver-operating characteristic analysis, a QRS duration > 139 ms and PDI > 0.57 could predict RVOT PVC-CMP (area under the curve (AUC) 0.710 and AUC 0.690, respectively). The elimination and suppression of PVCs by RFCA resulted in the recovery of the LVEF in RVOT PVC-CMP. Conclusions: The ECG parameters, including a wider QRS duration and higher PDI, could predict the development of RVOT PVC-CMP, which could be effectively treated by RFCA.

Original languageEnglish
Pages (from-to)175-185
Number of pages11
JournalJournal of Interventional Cardiac Electrophysiology
Volume53
Issue number2
DOIs
Publication statusPublished - Nov 1 2018

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Ventricular Premature Complexes
Cytidine Monophosphate
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Catheter Ablation
Polyvinyl Chloride
Stroke Volume
Area Under Curve
Electrocardiography
Pharmaceutical Preparations

Keywords

  • Catheter ablation
  • Electrocardiography
  • Premature ventricular complex-induced cardiomyopathy
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy. / Yamada, Shinya; Chung, Fa Po; Lin, Yenn Jiang; Chang, Shih Lin; Lo, Li Wei; Hu, Yu Feng; Chao, Tze Fan; Liao, Jo Nan; Lin, Chung-Hsing; Lin, Chin Yu; Chang, Yao Ting; Te, Abigail Louise D.; Liao, Ying Chieh; Chi, Po Ching; Chen, Shih Ann.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 53, No. 2, 01.11.2018, p. 175-185.

Research output: Contribution to journalArticle

Yamada, S, Chung, FP, Lin, YJ, Chang, SL, Lo, LW, Hu, YF, Chao, TF, Liao, JN, Lin, C-H, Lin, CY, Chang, YT, Te, ALD, Liao, YC, Chi, PC & Chen, SA 2018, 'Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy', Journal of Interventional Cardiac Electrophysiology, vol. 53, no. 2, pp. 175-185. https://doi.org/10.1007/s10840-018-0384-5
Yamada, Shinya ; Chung, Fa Po ; Lin, Yenn Jiang ; Chang, Shih Lin ; Lo, Li Wei ; Hu, Yu Feng ; Chao, Tze Fan ; Liao, Jo Nan ; Lin, Chung-Hsing ; Lin, Chin Yu ; Chang, Yao Ting ; Te, Abigail Louise D. ; Liao, Ying Chieh ; Chi, Po Ching ; Chen, Shih Ann. / Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy. In: Journal of Interventional Cardiac Electrophysiology. 2018 ; Vol. 53, No. 2. pp. 175-185.
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abstract = "Purpose: In spite of several proposed predictors for premature ventricular complex (PVC)-induced cardiomyopathy (PVC-CMP), the specific ECG features of idiopathic right ventricular outflow tract (RVOT) PVC-CMP remain unknown. Methods: A total of 130 patients (49 males, mean age 44 years) with symptomatic and drug-refractory idiopathic RVOT PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. The patients were categorized into two groups, including those with and without RVOT PVC-CMP (left ventricular ejection fraction (LVEF) < 50{\%}, n = 25 and LVEF ≥ 50{\%}, n = 105, respectively). The 12-lead PVC morphologies were assessed. Results: Patients with RVOT PVC-CMP had a lower LVEF (42 ± 5{\%} vs. 60 ± 7{\%}, P < 0.01) and higher PVC burden (24 ± 14{\%} vs. 15 ± 11{\%}, P = 0.02) when compared to patients without RVOT PVC-CMP. The PVC features in those with PVC-CMP displayed a significantly wider QRS duration (143 ± 14 ms vs. 132 ± 17 ms, P < 0.01) and higher peak deflection index (PDI; 0.60 ± 0.07 vs. 0.55 ± 0.08, P < 0.01). A multivariate analysis demonstrated that the QRS duration (odds ratio (OR) 1.130, 95{\%} confidence interval (CI) 1.020–1.253, P = 0.02) and PDI (OR 1.240, 95{\%} CI 1.004–1.532, P = 0.04) were independently associated with RVOT PVC-CMP. Based on the receiver-operating characteristic analysis, a QRS duration > 139 ms and PDI > 0.57 could predict RVOT PVC-CMP (area under the curve (AUC) 0.710 and AUC 0.690, respectively). The elimination and suppression of PVCs by RFCA resulted in the recovery of the LVEF in RVOT PVC-CMP. Conclusions: The ECG parameters, including a wider QRS duration and higher PDI, could predict the development of RVOT PVC-CMP, which could be effectively treated by RFCA.",
keywords = "Catheter ablation, Electrocardiography, Premature ventricular complex-induced cardiomyopathy, Ventricular arrhythmia",
author = "Shinya Yamada and Chung, {Fa Po} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Chao, {Tze Fan} and Liao, {Jo Nan} and Chung-Hsing Lin and Lin, {Chin Yu} and Chang, {Yao Ting} and Te, {Abigail Louise D.} and Liao, {Ying Chieh} and Chi, {Po Ching} and Chen, {Shih Ann}",
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T1 - Electrocardiographic characteristics for predicting idiopathic right ventricular outflow tract premature ventricular complex-induced cardiomyopathy

AU - Yamada, Shinya

AU - Chung, Fa Po

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Chao, Tze Fan

AU - Liao, Jo Nan

AU - Lin, Chung-Hsing

AU - Lin, Chin Yu

AU - Chang, Yao Ting

AU - Te, Abigail Louise D.

AU - Liao, Ying Chieh

AU - Chi, Po Ching

AU - Chen, Shih Ann

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Purpose: In spite of several proposed predictors for premature ventricular complex (PVC)-induced cardiomyopathy (PVC-CMP), the specific ECG features of idiopathic right ventricular outflow tract (RVOT) PVC-CMP remain unknown. Methods: A total of 130 patients (49 males, mean age 44 years) with symptomatic and drug-refractory idiopathic RVOT PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. The patients were categorized into two groups, including those with and without RVOT PVC-CMP (left ventricular ejection fraction (LVEF) < 50%, n = 25 and LVEF ≥ 50%, n = 105, respectively). The 12-lead PVC morphologies were assessed. Results: Patients with RVOT PVC-CMP had a lower LVEF (42 ± 5% vs. 60 ± 7%, P < 0.01) and higher PVC burden (24 ± 14% vs. 15 ± 11%, P = 0.02) when compared to patients without RVOT PVC-CMP. The PVC features in those with PVC-CMP displayed a significantly wider QRS duration (143 ± 14 ms vs. 132 ± 17 ms, P < 0.01) and higher peak deflection index (PDI; 0.60 ± 0.07 vs. 0.55 ± 0.08, P < 0.01). A multivariate analysis demonstrated that the QRS duration (odds ratio (OR) 1.130, 95% confidence interval (CI) 1.020–1.253, P = 0.02) and PDI (OR 1.240, 95% CI 1.004–1.532, P = 0.04) were independently associated with RVOT PVC-CMP. Based on the receiver-operating characteristic analysis, a QRS duration > 139 ms and PDI > 0.57 could predict RVOT PVC-CMP (area under the curve (AUC) 0.710 and AUC 0.690, respectively). The elimination and suppression of PVCs by RFCA resulted in the recovery of the LVEF in RVOT PVC-CMP. Conclusions: The ECG parameters, including a wider QRS duration and higher PDI, could predict the development of RVOT PVC-CMP, which could be effectively treated by RFCA.

AB - Purpose: In spite of several proposed predictors for premature ventricular complex (PVC)-induced cardiomyopathy (PVC-CMP), the specific ECG features of idiopathic right ventricular outflow tract (RVOT) PVC-CMP remain unknown. Methods: A total of 130 patients (49 males, mean age 44 years) with symptomatic and drug-refractory idiopathic RVOT PVCs undergoing radiofrequency catheter ablation (RFCA) were enrolled. The patients were categorized into two groups, including those with and without RVOT PVC-CMP (left ventricular ejection fraction (LVEF) < 50%, n = 25 and LVEF ≥ 50%, n = 105, respectively). The 12-lead PVC morphologies were assessed. Results: Patients with RVOT PVC-CMP had a lower LVEF (42 ± 5% vs. 60 ± 7%, P < 0.01) and higher PVC burden (24 ± 14% vs. 15 ± 11%, P = 0.02) when compared to patients without RVOT PVC-CMP. The PVC features in those with PVC-CMP displayed a significantly wider QRS duration (143 ± 14 ms vs. 132 ± 17 ms, P < 0.01) and higher peak deflection index (PDI; 0.60 ± 0.07 vs. 0.55 ± 0.08, P < 0.01). A multivariate analysis demonstrated that the QRS duration (odds ratio (OR) 1.130, 95% confidence interval (CI) 1.020–1.253, P = 0.02) and PDI (OR 1.240, 95% CI 1.004–1.532, P = 0.04) were independently associated with RVOT PVC-CMP. Based on the receiver-operating characteristic analysis, a QRS duration > 139 ms and PDI > 0.57 could predict RVOT PVC-CMP (area under the curve (AUC) 0.710 and AUC 0.690, respectively). The elimination and suppression of PVCs by RFCA resulted in the recovery of the LVEF in RVOT PVC-CMP. Conclusions: The ECG parameters, including a wider QRS duration and higher PDI, could predict the development of RVOT PVC-CMP, which could be effectively treated by RFCA.

KW - Catheter ablation

KW - Electrocardiography

KW - Premature ventricular complex-induced cardiomyopathy

KW - Ventricular arrhythmia

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U2 - 10.1007/s10840-018-0384-5

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