Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin

Abstract Purpose To compare the predictive accuracy of five different algorithms as verified by successful ablation site using 3D electroanatomical non-contact mapping in patients with symptomatic and asymptomatic but high ventricular burden RVOT tachycardias. Methods 28 Consecutive patients admitte...

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Autores principales:	Raluca Sirbu Prisecaru, Cristina Leatu, Leila Riahi, Victor Costache
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Right ventricular outflow tract origin Ventricular premature beats Algorithms Radiofrequency ablation Left bundle branch block morphology Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/52a3be1e68244446bb00c5d42ad717e4
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spelling	oai:doaj.org-article:52a3be1e68244446bb00c5d42ad717e42021-12-05T12:20:52ZEvaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin10.1186/s42444-021-00050-y2466-1171https://doaj.org/article/52a3be1e68244446bb00c5d42ad717e42021-12-01T00:00:00Zhttps://doi.org/10.1186/s42444-021-00050-yhttps://doaj.org/toc/2466-1171Abstract Purpose To compare the predictive accuracy of five different algorithms as verified by successful ablation site using 3D electroanatomical non-contact mapping in patients with symptomatic and asymptomatic but high ventricular burden RVOT tachycardias. Methods 28 Consecutive patients admitted for radiofrequency catheter ablation for symptomatic and asymptomatic, but high ventricular burden idiopathic VPC were recruited for this study. All patients had previous failed or intolerant to beta-blocker and/or at least one class IC anti-arrhythmic agents, and they had normal left ventricular ejection fraction. All patients had documented monomorphic VPC with left bundle branch block morphology and an inferior axis. Concordance of the arrhythmia origin based on ECG algorithm and 3D mapping system site were further evaluated. Of the five algorithms, two algorithms with easy‐applicability and having a memorable design (Dixit and Joshi) and three algorithms with more complex and detailed design (Ito, Zhang, Pytkowski) were selected for comparisons. Results Assessment of the diagnostic accuracy showed that each of the five algorithms had only moderate accuracy, and the greatest accuracy was observed in the algorithm proposed by Pytkowski algorithm when assessed by a general cardiologist and Dixit algorithm when evaluated by the electrophysiologist. However, when the algorithms were compared for their accuracy, specificity, sensitivity, no significant differences were found (p = 0.99). Conclusions The ECG based algorithms for precise localising RVOTA origin simplify the mapping process, reduce the procedural and fluoroscopic time, and improve clinical outcomes, resulting in greater clinical utility. All the five published 12-lead ECG algorithms for ROTVA differentiation were similar in terms of the diagnostic accuracy, specificity, sensitivity and LRs.Raluca Sirbu PrisecaruCristina LeatuLeila RiahiVictor CostacheBMCarticleRight ventricular outflow tract originVentricular premature beatsAlgorithmsRadiofrequency ablationLeft bundle branch block morphologyDiseases of the circulatory (Cardiovascular) systemRC666-701ENInternational Journal of Arrhythmia, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Right ventricular outflow tract origin Ventricular premature beats Algorithms Radiofrequency ablation Left bundle branch block morphology Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Right ventricular outflow tract origin Ventricular premature beats Algorithms Radiofrequency ablation Left bundle branch block morphology Diseases of the circulatory (Cardiovascular) system RC666-701 Raluca Sirbu Prisecaru Cristina Leatu Leila Riahi Victor Costache Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
description	Abstract Purpose To compare the predictive accuracy of five different algorithms as verified by successful ablation site using 3D electroanatomical non-contact mapping in patients with symptomatic and asymptomatic but high ventricular burden RVOT tachycardias. Methods 28 Consecutive patients admitted for radiofrequency catheter ablation for symptomatic and asymptomatic, but high ventricular burden idiopathic VPC were recruited for this study. All patients had previous failed or intolerant to beta-blocker and/or at least one class IC anti-arrhythmic agents, and they had normal left ventricular ejection fraction. All patients had documented monomorphic VPC with left bundle branch block morphology and an inferior axis. Concordance of the arrhythmia origin based on ECG algorithm and 3D mapping system site were further evaluated. Of the five algorithms, two algorithms with easy‐applicability and having a memorable design (Dixit and Joshi) and three algorithms with more complex and detailed design (Ito, Zhang, Pytkowski) were selected for comparisons. Results Assessment of the diagnostic accuracy showed that each of the five algorithms had only moderate accuracy, and the greatest accuracy was observed in the algorithm proposed by Pytkowski algorithm when assessed by a general cardiologist and Dixit algorithm when evaluated by the electrophysiologist. However, when the algorithms were compared for their accuracy, specificity, sensitivity, no significant differences were found (p = 0.99). Conclusions The ECG based algorithms for precise localising RVOTA origin simplify the mapping process, reduce the procedural and fluoroscopic time, and improve clinical outcomes, resulting in greater clinical utility. All the five published 12-lead ECG algorithms for ROTVA differentiation were similar in terms of the diagnostic accuracy, specificity, sensitivity and LRs.
format	article
author	Raluca Sirbu Prisecaru Cristina Leatu Leila Riahi Victor Costache
author_facet	Raluca Sirbu Prisecaru Cristina Leatu Leila Riahi Victor Costache
author_sort	Raluca Sirbu Prisecaru
title	Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
title_short	Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
title_full	Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
title_fullStr	Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
title_full_unstemmed	Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin
title_sort	evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (rvota) when compared to 3d electroanatomical mapping origin
publisher	BMC
publishDate	2021
url	https://doaj.org/article/52a3be1e68244446bb00c5d42ad717e4
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Evaluation of five algorithms in predicting the sublocalisation of right ventricular outflow tract arrhythmia (RVOTA) when compared to 3D electroanatomical mapping origin

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