The Relation Between the Pacing Sites in the Right Ventricular Outflow Tract and QRS Morphology in the 12-Lead ECG

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概要

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• Optimal pace mapping is a good predictor of the appropriate ablation site for idiopathic right ventricular tachycardia(VT)originating from the right ventricular outflow tract(RVOT).We studied the relationship between the RVOT pacing site and QRS morphology in the 12-lead ECG during pacing to find the optimal site more quickly.In 13 patients with idiopathic VT, pacing at 8 sites in the RVOT(free wall, septum, and anterior and posterior regions of upper and lower sites)was performed while 12-lead ECGs were recorded.The R-wave amplitude minus the S-wave amplitude in lead I(R_I-S_I)and aV_F(R_aVF-S_aVF)and the transitional zone index(TZI)were compared in the different pacing sites;TZI was defined to examine the transitional zone as a value.The R_I-S_I was smaller in the anterior region than in the other regions, and the negative R_I-S_I perdicted that the pacing site was in the upper or lower anterior regions.The R_aVf-S_aVF was larger in the septum and anterior regions than in the free wall and posterior regions.The TZI was larger in the free wall region than in the septum.From the results, we constructed a flow chary that differentiates the origin of the arrhythmia in the RVOT and a directional guide that indicates the direction from the current mapping site for optimal pace mapping.The results provided an ECG guide for locating the focus of VT originating from the RVOT.These findings may systematically improve the mapping procedure.

• 社団法人日本循環器学会の論文
• 1998-05-20

著者

• Shimizu Hiroki

  First Department of Internal Medicine, Hyogo College of Medicine

• INOUE Tomoo

  Division of Surgery,Tokushukai Nozaki Hospital

• Yokoyama Mitsuhiro

  ()

• Yokoyama Mitsuhiro

  富山大学 医学部バイオ統計学臨床疫学

• Yokoyama Mitsuhiro

  Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University

• Yokoyama Mitsuhiro

  First Department Of Internal Medicine Kobe University School Of Medicine

• Inoh Tsutomu

  Kobe University School Of Medicine First Department Of Internal Medicine

• Inoue Tomoo

  First Department Of Internal Medicine Kobe University School Of Medicine

• Ohnishi Yoshio

  First Department of Internal Medicine Kobe University School of Medicine

• Sekiya Junichi

  First Department of Internal Medicine, Kobe University School of Medicine

• Shima takashi

  First Department of Internal Medicine, Kobe University School of Medicine

• Yoshida Akihiro

  Division of Cardiovascular Medicine, Himeji Cardiovascular Center

• Itagaki Takeshi

  Division of Cardiovascular Medicine, Himeji Cardiovascular Center

• Sekiya Junichi

  Division of Internal Medicine, Sanda City Hospital

• Yamashiro Kouhei

  First Department of Internal Medicine, Kobe University School of Medicine

• Takei Asumi

  First Department of Internal Medicine, Kobe University School of Medicine

• Adachi Kazumasa

  First Department of Internal Medicine, Kobe University School of Medicine

• Ohnishi Yoshio

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Ohnishi Yoshio

  Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University

• Adachi Kazumasa

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Yamashiro Kouhei

  First Department Of Internal Medicine Kobe University School Of Medicine

• Yamashiro Kouhei

  Department Of Cardiology Himeji Cardiovascular Center

• Inoh Tsutomu

  Department Of Internal Medicine Devision I Kobe University School Of Medicine

• Shima Takashi

  First Department Of Internal Medicine Kobe University School Of Medicine

• Shimizu Hiroki

  First Department Of Medicine Hyogo College Of Medicine

• Sekiya Junichi

  First Department Of Internal Medicine Kobe University School Of Medicine

• Shimizu Hiroki

  First Department Of Internal Medicine Hyogo College Of Medicine

• Yoshida Akihiro

  Kobe University Graduate School of Medicine

• Takei Asumi

  First Department Of Internal Medicine Kobe University School Of Medicine

• Itagaki Takeshi

  The First Department Of Internal Medicine Kobe University School Of Medicine

• Inoue Tomoo

  From The First Department Of Internal Medicine Kobe University School Of Medicine

• Yokoyama Mitsuhiro

  First Department Of Internal Medicine Kobe University

• Yoshida Akihiro

  Division Of Cardiology Department Of Internal Medicine St. Marianna University School Of Medicine

• Inoue Tomoo

  Division Of Surgery Tokushukai Nozaki Hospital

• Inoue Tomoo

  First Department Of Internal Medicine. Kobe University School Of Medicine

• Ohnishi Yoshio

  Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University

• Yoshida Akihiko

  Department Of Internal Medicine Division Of Cardiovascular Medicine Kobe University Graduate School

• Yokoyama Mitsuhiro

  First Department Of Internal Medicine

• ITAGAKI Takeshi

  Division of Cardiology, Sanda City Hospital

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