Location Diagnosis And Diagnosis Of Ventricular Premature Contraction Of Outflow Tract And Radiofrequency Ablation

Purpose:1.To investigate the characteristics of surface electrocardiogram?ECG?of outflow ventricular premature beats?PVC?;2.Explore three quantitative indicators(Transition zone integral index,I_TZI),V₂S/V₃R index(V₂S/V₃R index,I_V2S/V3R),R wave time limit index,I_RTL)The diagnostic value of the location of the origin of the outflow tract ventricular premature beat?PVC?;3.Study and compare the efficacy of RF ablation under the guidance of PVC in 3D and2D respectively Method:1.Retrospective analysis of 100 patients with VOT-PVC who underwent catheter ablation under the guidance of Carto3,33 patients with left ventricular outflow tract?LVOT?and 67 patients with right ventricular outflow tract?RVOT?.Ablation target map and surface ECG characteristics;2.Observe the changes of QRS wave in the chest lead PVC QRS wave and sinus beat,analyze the I_TZI,I_V2S/V3R,I_RTLTL and its sensitivity and specificity;3.Follow-up patients with recurrence rate.Result:1.RVOT and LVOT surface ECG general characteristics:VOT often shows II,III,aVF unidirectional vertical R wave,LOVT-PVC migration is significantly earlier than ROVT-PVC,LVOT-PVC transition zone is mostly in V₁,V₂ lead,accounting for 63.6%,V₂^V₃ accounted for 33.3%between the two leads,ROVT-PVC transition zone mostly in V₃ lead and later accounted for 70.1%?47/67?,V₂^V₃ led between 14.9%?10/?67);2,LVOT QRS wave time limit standard deviation is 142±11.12 ms,RVOT QRS wave time limit standard deviation is 137±10.10 ms,P<0.01,no statistical difference;QRS wave upright high R wave is not smooth,ROVT has 55 patients origin From the septum,12 patients had free wall of origin,LVOT had 33 patients,and 5,11,and 3 patients with R-wave surface were not smooth.X²=39.857,P<0.01.3.There is a significant difference between the LOVT-PVC transition zone integral and the ROVT-PVC transition zone integral?P<0.01?.LVOT-PVC transition zone?TZ?compared with sinus beats,the migration is earlier;LVOT-PVC transition zone integral index<0.81.8%?27/33?,RVOT-PVC'TZ compared to sinus heart Beat more late.The RVOT-PVC transition zone integral index>0 accounted for 73.1%?49/67?,the LOVT-PVC transition zone integral index was significantly lower than the ROVT-PVC transition zone integral index?P<0.01?;4.LVOT-PVC V₂S/V₃R index>1.5 with75.6%?25/33?,ROVT-PVC V₂S/V₃R index<1.5 with 89.6%?60/67?,the former V₂S/V₃R index is significantly lower than the latter(P<0.01];LVOT-PVC V₂ R time limit index]>0.5 has 75.8%?25/33?,RVOT-PVC R wave time limit index>0.5 accounted for25.4%?17/67?,statistical analysis,LVOT-PVC The I_RTLTL is significantly larger than the RVOT-PVC.5.When the V₂ S/V₃R index is 2.17,the transition index of the transition zone is 0.25,and the V₂R time limit index is 0.525,the diagnostic value of the outflow tract premature beat is the highest,and the corresponding sensitivity and specificity are83.6%and 91.0 respectively.%,87.9%and 81.8%,69.7%and 83.6%.6,Carto3 guided LVOT-PVC radiofrequency ablation recurrence rate was 15.4%,RVOT-PVC radiofrequency ablation recurrence rate was 3.7%,statistical analysis X²=1.726,P=0.189;X-ray fluoroscopy guided radiofrequency ablation patients grouped as The recurrence rates of LVOT-PVC and RVOT-PVC were 16.6%and 14.3%,respectively.The statistical analysis showed that X²=0.118,P=0.891,no clinical significance.Carto3 guided catheter ablation group and X-ray fluoroscopy catheter ablation group dynamic electrocardiographic premature beat reduction>75%of 37 cases?92.5%?,17 cases?85%?were statistically analyzed X²=0.208,P=0.374,no Significantly statistically significant.In conclusion:1.TZ of LVOT-PVC is early,TL of LVOT-PVC is high in V₁ and V₂,and TL of RVOT-PVC is high in V₃ and later.The QRS wave time limit has little clinical significance for the localization diagnosis of VOT-PVC.The QRS wave of PVC II,III and aVF has surface roughness,which has certain clinical value for judging the origin of RVOT-PVC free wall.2.I_TZI,I_V2S/V3R,and I_RTLTL have significant clinical significance for the differential diagnosis of LVOT-PVC and RVOT-PVC,especially VOT-PVC transition between V₂and V₃ leads;and I_TZIZI for the location of outflow tract premature beats Diagnostic sensitivity and specificity are highest.3.There was no significant difference in the recurrence rate of catheter ablation under the guidance of Carto3.There was no significant difference in the recurrence rate between LVOT-PVC and RVOT-PVC.