Electrocardiographic characteristics and radiofrequency catheter ablation of ventricular tachycardia or premature ventricular contraction originating from the aortomitral continuity

Objective To evaluate the electrocardiographic (ECG) characteristics and effects of radiofrequency catheter ablation (RFCA) in patients with idiopathic ventricular tachycardia (IVT) or premature ventricular contraction (PVC) originating from the aortomitral continuity (AMC). Methods 868 IVT/PVC patients received RFCA from May 2009 to Oct 2014, among whom 19 patients were diagnosed as VT/PVC originated in AMC. The 12 leads (ECG) characteristics of the AMC VT/PVC were analyzed. Results The 12-lead ECG patterns of AMC originated VT/PVC were characterized by: R wave in lead V1, R/S transition pattern (zone) in V1 leads, Rs wave in lead V2-V3(or V4), rs wave in lead Ⅰ, high R wave in lead Ⅱ、Ⅲ、aVF with R wave rise and fall section symmetry, RⅢ≥RⅡ, and QS wave in both lead aVR and aVL. The IVT/PVCs were successfully eliminated by RFCA in 18 cases. The VT/PVCs were originated from the aortomitral continuity in the 18 cases. RFCA failed in one case. Conclusion IVT/PVC originated in AMC was a distinct subgroup of IVT/PVC which can be successfully treated by RFCA. 12-leads ECG analysis is a powerful tool in determining the exact origin of these IVT/PVC. Key words: Premature ventricular contraction; Ventricular tachycardia; Electrocardiogram; Radiofrequency catheter ablation