Ventricular extrasystoles: QRS intrinsiccoid deflection relationship to discriminate the origin

Extrasístoles ventriculares: relación deflexión intrinsecoide / QRS para discriminar el origen

Introduction: Outflow tract ventricular tachycardia (VT) and premature ventricular complexes (PVC) are common ventricular arrhythmias that occur in the structurally normal heart. Interventional management using ablation procedures in selected cases has demonstrated good therapeutic efficacy; diagnostic aids supplementary to extensión studies have been designed to optimize the target ablation site based on the site of origin. Objective: to propose a tool for early diagnosis of ventricular extrasystoles originating at the outflow tracts by calculating the time to intrinsicoid deflection / QRS measured in lead V6. Materials and Methods: a cross sectional study conducted in patients diagnosed with PVC who underwent an electrophysiological evaluation and a successful ablation procedure. We measured the time to intrinsicoid deflection or onset of the QRS complex to the peak of the R wave in V6. Results: the value of the intrinsicoid deflection /QRS time resulting from the cut off points analysis was less than or equal to 0.67 for the right ventricle and greater than or equal to 0.68 for the left ventricle. Data analysis provided a correct classification of patients in 80% of cases. Conclusions: this study proposes a short and simple predictive tool of the site of origin of these arrhythmias by measuring some electrocardiographic features showing said ventricular extrasystoles in V6, where it is possible to identify the site of origin of arrhythmias prior to an interventional procedure.

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