Arrhythmias & electrophysiology
Sinus rhythm electrocardiographic abnormalities, sites of origin, and ablation outcomes of ventricular premature depolarizations initiating ventricular fibrillation
Authors' conclusion
A reduced QRS amplitude (<0.55 mV) in aVF, QRSf in ≥2 contiguous leads, and/or an ER pattern are frequently observed in patients with VPDs initiating VF. VPDs initiating VF typically originate from the distal Purkinje system and papillary muscles and can be successfully eliminated with catheter ablation.
Study context
- Population
- Patients with ventricular premature depolarizations (VPDs) (ventricular premature depolarizations) without structural heart disease
- Participants
- 42 vs 61
- Exposure
- Patients with VPDs initiating ventricular fibrillation (VF) vs patients with symptomatic unifocal VPDs
- Group 1n = 42
- Group 2n = 61reference
- Outcome
- Prevalence of sinus rhythm electrocardiographic (ECG) reduced QRS amplitude, QRS fractionation (QRSf) and early repolarization (ER) pattern
Main finding
As reported in the abstract
Reduced QRS amplitude (<0.55 mV) in aVF
QRSf in ≥2 contiguous leads
P < 0.001
ER pattern
P = 0.01
| Outcome | Group 1 | Group 2 | P value |
|---|---|---|---|
| ≥1 abnormal ECG finding | 34 (81%) | 17 (28%) | P < 0.001 |
- Group 1 vs Group 2: P < 0.001 — reduced QRS amplitude in aVF
Observational data: associations, not effects.
Further findings
VPD origin in RV/LV distal Purkinje system and moderator band/papillary muscles
P < 0.001
- VF eliminated with a single ablation procedure (Group 1) · ≥2 years of follow-up
- 77%
Original publication
Sinus rhythm electrocardiographic abnormalities, sites of origin, and ablation outcomes of ventricular premature depolarizations initiating ventricular fibrillation. Heart Rhythm. Published 21 March 2023. doi:10.
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