Abstract

Background

There is limited data regarding the effect of idiopathic premature ventricular complexes (PVC) on myocardial repolarisation. Most of PVC’s originate from right and left ventricular outflow tracts (RVOT and LVOT).

Aim

The aim of this study is to evaluate the acute effect of outflow tract PVC ablation on electrocardiographic repolarisation markers.

Methods

A total of 180 patients (49.2 ± 13.6 years, 74 male) without any exclusion criteria who had undergone outflow tract PVC ablation between 1 January 2015 and 1 November 2018 constituted our study population. Electrocardiographic recordings that had been obtained before and after ablation procedure on the same day were retrospectively evaluated for the QTc dispersion, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Significance of difference between pre- and postablation values was tested.

Results

There was no significant difference regarding QTc dispersion between pre- and post-ablation state (36.5 ± 20.9 vs. 35.3 ± 16.4 ms, p: NS). However, Tp-e and Tp-e/QT values in all lateral precordial derivations were observed to decrease significantly after PVC ablation (in the respective order on derivation V5: 104.0 ± 21.6 ms vs. 91.1 ± 14.8 ms, p<.001 and 0.26 ± 0.05 vs. 0.23 ± 0.04, p<.001).

Conclusions

Based on these observations, it may be suggested that frequent outflow tract PVC’s increase transmural dispersion of repolarisation and this effect is attenuated by catheter ablation in the acute phase. Results of further prospective studies are required for evaluation of the long term effects of PVC ablation on myocardial repolarisation.

中文翻译：

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流出道室性早搏消融对QT离散度、Tp-e间期和Tp-e/QT比值的急性影响

摘要

背景

关于特发性室性早搏 (PVC) 对心肌复极的影响的数据有限。大多数 PVC 起源于右心室和左心室流出道（RVOT 和 LVOT）。

目标

本研究的目的是评估流出道 PVC 消融对心电图复极标志物的急性影响。

方法

共有 180 名在 2015 年 1 月 1 日至 2018 年 11 月 1 日期间接受流出道 PVC 消融的无任何排除标准的患者（49.2 ± 13.6 岁，74 名男性）构成了我们的研究人群。回顾性评估同一天消融手术前后获得的心电图记录的QTc离散度、Tp-e间期、Tp-e/QT比值和Tp-e/QTc比值。测试了消融前和消融后值之间差异的显着性。

结果

消融前和消融后状态之间的 QTc 离散度没有显着差异（36.5 ± 20.9 vs. 35.3 ± 16.4 ms，p：NS）。然而，在 PVC 消融后，观察到所有外侧胸前推导的 Tp-e 和 Tp-e/QT 值显着降低（推导 V5 的相应顺序：104.0 ± 21.6 ms与91.1 ± 14.8 ms，p <.001 和0.26 ± 0.05与0.23 ± 0.04，p <.001)。

结论

基于这些观察，可能表明频繁的流出道 PVC 会增加复极化的透壁弥散，并且这种效应在急性期通过导管消融而减弱。需要进一步的前瞻性研究结果来评估 PVC 消融对心肌复极的长期影响。