Second coupling interval of nonsustained ventricular tachycardia to distinguish malignant from benign outflow tract
Yoo Ri Kim1, Gi-Byoung Nam1, Chang Hee Kwon1
1Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Background:
Idiopathic ventricular tachycardia (VT) originating from the outflow tract (OT) usually is considered a benign condition. In rare cases, patients with OT-VT suffer from syncope or even sudden cardiac death. OT-VT is frequently preceded by nonsustained VT (NSVT).
Objective:
The purpose of this study was to clarify if the ECG parameters of NSVTs could differentiate malignant from benign OT-VT.
Methods:
We retrospectively evaluated patients without structural heart disease who had documented OT-NSVT on ECG. ECG parameters were compared between patients with syncope, aborted sudden cardiac death, or ventricular fibrillation (malignant group, n = 36) and patients without syncope (benign group, n = 40).
Results:
There were no differences with regard to age and gender between the malignant and benign groups. On analysis of NSVT, the first coupling interval (CI) of NSVT was comparable between the 2 groups (458 ± 87 ms vs 485 ± 95 ms, P = .212). However, the second CI of NSVT beats was significantly shorter in the malignant group (313 ± 58 ms vs 385 ± 83 ms, P < .0001). During 48-month follow-up, the benign group had a significantly lower recurrence of clinical VT than the malignant group (P = .046). The malignant group frequently had more than 1 focus of VT, whereas the benign group showed only a single focus (1.82 vs 1.09, P = .023).
Conclusion:
The second CI of NSVT in the malignant group was significantly shorter than that of the benign OT-VT group. Careful measurement of the second CI of NSVT may help identify the malignant form of OT-VT, enabling early treatment to prevent future cardiac events.
More Related Videos
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
Related Concept Videos
01:28Dysrhythmias II: Classification of Tachyarrhythmias
01:29Dysrhythmias III: Characteristics of Dysrhythmias
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials