An easy measurement to predict the left vs. right premature ventricular
contractions: CS distal delay interval
Abstract
Aim: We aimed to detect the predictive value of CS distal delay
interval for differentiating the left from right sided PVCs.
Methods: We included 137 patients with symptomatic frequent
premature ventricular contractions (PVCs) who underwent successful
catheter ablation retrospectively (67 male, 70 female; mean age 46.0 ±
16.2 years). Patients were classified into two groups as left sided and
right sided PVCs. Decapolar catheters were placed in the coronary sinus
before the procedure. CS distal delay interval (Q-CSd) was measured as
the interval from onset of earliest QRS complex of premature ventricular
contractions in 12 lead ECG to distal CS EGM signal. Results:
CS distal delay interval was found to be significantly lower in left
sided PVCs. The cutoff value of CS distal delay interval obtained by ROC
curve analysis was 48,5 ms for prediction of right sided origin
(sensitivity: 91,5%, specificity: 85.9%). The area under the curve
(AUC) was 0.911 (p<0.001). Conclusion: CS distal
delay interval is a novel and simple measurement for accurately
differentiating the left from right sided PVCs. The use of this simple
measurement could be beneficial for decreasing ablation duration,
radiation exposure and the number of arterial or venous punctures.