Objective To place pacing electrodes in the anterior sinus,left sinus,and right sinus of the pulmonary artery using catheter technology to obtain twelve-lead multilead electrocardiogram(ECG)and to analyze the ECG characteristics during pacing in these sinuses,thereby providing references for the localization and ablation treatment of right ventricular outflow tract (RVOT)premature ventricular contractions(PVCs).Methods A total of 40 patients diagnosed with PVCs of the RVOT who underwent radiofrequency ablation at our hospital from 2021 to 2023 were included.During the procedure,the ablation catheter was manipulated into a reversed U-curve position within the three sinuses of the pulmonary artery,confirmed by contrast imaging at right anterior oblique 30 degrees and left anterior oblique 45 degrees.Twelve-lead ECGs were obtained through pacing in each of the sinuses.Results A total of 105 ECGs were successfully obtained from the 40 patients during pulmonary sinus cusp pacing.The ECG characteristics for pacing from the right sinus were distinct,with 83.3％ showing a positive wave in lead Ⅰ,and 64.7％ showing a migration of the thoracic leads later than the V3 leads.The lower wall leads(Ⅱ,Ⅲ,and AVF)had a descending branch notch in 73.5％,64.7％,and 70.6％ of cases,respectively,which was statistically different from the characteristics observed with pacing from the left sinus and anterior sinus(P<0.05).There was no statistical difference in thoracic lead migration and the descending branch incisor of the lower wall lead while comparing the left sinus to the anterior sinus,except for the morphology of lead I(P>0.05).Conclusion The twelve-lead ECGs produced during pacing in the right sinus,anterior sinus,and left sinus of the pulmonary artery each have their unique characteristics.Understanding these ECG characteristics is of significant reference value for clinicians during the localization and ablation treatment of right ventricular outflow tract PVCs,which can improve the success rate and efficiency of the surgery.
Right ventricular outflow tractRadiofrequency ablationPacing ECGPulmonary sinus cusp
万方数据
维普
