Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar

Chin Yu Lin; Fa Po Chung; Yenn Jiang Lin; Yun Yu Chen; Shih Lin Chang; Li Wei Lo; Yu Feng Hu; Jo Nan Liao; Ta Chuan Tuan; Tze Fan Chao; Abigail Louise D. Te; Shinya Yamada; Ling Kuo; Jennifer Jeanne B. Vicera; Ting Yung Chang; Simon Salim; Ting Chung Huang; Chih Min Liu; Cheng I. Wu; Shih Ann Chen

doi:10.1007/s10840-019-00512-3

Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar

Chin Yu Lin, Fa Po Chung, Yenn Jiang Lin^*, Yun Yu Chen, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Jo Nan Liao, Ta Chuan Tuan, Tze Fan Chao, Abigail Louise D. Te, Shinya Yamada, Ling Kuo, Jennifer Jeanne B. Vicera, Ting Yung Chang, Simon Salim, Ting Chung Huang, Chih Min Liu, Cheng I. Wu, Shih Ann Chen

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醫學系內科學科

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摘要

Purpose: The right ventricular (RV) septal unipolar voltage (UV) for predicting left ventricular (LV) septal scar wall thickness (WT) remains to be elucidated. Methods: From 2013 to 2015, data obtained from RV and LV electroanatomic maps of 28 patients (mean age, 53 ± 16 years; 19 men [67.9%]) with/without identified LV septal scars were reviewed. Patients with an RV septal scar were excluded (n = 90). Direct measurement of septal WT was conducted (mean distance, 10.4 ± 3.3 mm). Patients in group 1 had a normal LV substrate, while those in group 2 had an LV septal scar. Fisher’s linear discriminant formula was used to determine the dynamic UV criteria. Results: A total of 552 points were collected: 323 in 12 patients from group 1 and 229 in 16 patients from group 2. The UV of the RV septum is capable of identifying the opposite LV endocardial bipolar scar and is proportional to the WT of the interventricular septum. In the absence of an RV endocardial scar, the formula of “RV septal cut-off value = 0.736 × WT − 0.117 mV” has better sensitivity and specificity for predicting the LV septal scar (0.96 vs. 0.68 and 0.91 vs. 0.80, respectively) than the predefined fixed criteria of 8.3 mV with a net reclassification improvement of 25.7% (P < 0.001). Conclusions: The combined measurement of UV and WT is more sensitive than the predefined fixed UV criteria for defining deep scars.

原文	English
頁（從 - 到）	353-359
頁數	7
期刊	Journal of Interventional Cardiac Electrophysiology
卷	57
發行號	3
DOIs	https://doi.org/10.1007/s10840-019-00512-3
出版狀態	Published - 1 4月 2020

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10.1007/s10840-019-00512-3

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Lin, C. Y., Chung, F. P., Lin, Y. J., Chen, Y. Y., Chang, S. L., Lo, L. W., Hu, Y. F., Liao, J. N., Tuan, T. C., Chao, T. F., Te, A. L. D., Yamada, S., Kuo, L., Vicera, J. J. B., Chang, T. Y., Salim, S., Huang, T. C., Liu, C. M., Wu, C. I., & Chen, S. A. (2020). Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar. Journal of Interventional Cardiac Electrophysiology, 57(3), 353-359. https://doi.org/10.1007/s10840-019-00512-3

@article{86ab5b31acc949159c65a208d935e83c,

title = "Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar",

abstract = "Purpose: The right ventricular (RV) septal unipolar voltage (UV) for predicting left ventricular (LV) septal scar wall thickness (WT) remains to be elucidated. Methods: From 2013 to 2015, data obtained from RV and LV electroanatomic maps of 28 patients (mean age, 53 ± 16 years; 19 men [67.9%]) with/without identified LV septal scars were reviewed. Patients with an RV septal scar were excluded (n = 90). Direct measurement of septal WT was conducted (mean distance, 10.4 ± 3.3 mm). Patients in group 1 had a normal LV substrate, while those in group 2 had an LV septal scar. Fisher{\textquoteright}s linear discriminant formula was used to determine the dynamic UV criteria. Results: A total of 552 points were collected: 323 in 12 patients from group 1 and 229 in 16 patients from group 2. The UV of the RV septum is capable of identifying the opposite LV endocardial bipolar scar and is proportional to the WT of the interventricular septum. In the absence of an RV endocardial scar, the formula of “RV septal cut-off value = 0.736 × WT − 0.117 mV” has better sensitivity and specificity for predicting the LV septal scar (0.96 vs. 0.68 and 0.91 vs. 0.80, respectively) than the predefined fixed criteria of 8.3 mV with a net reclassification improvement of 25.7% (P < 0.001). Conclusions: The combined measurement of UV and WT is more sensitive than the predefined fixed UV criteria for defining deep scars.",

keywords = "Fisher{\textquoteright}s linear discriminant formula, Septal scar, Unipolar voltage, Wall thickness",

author = "Lin, {Chin Yu} and Chung, {Fa Po} and Lin, {Yenn Jiang} and Chen, {Yun Yu} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Liao, {Jo Nan} and Tuan, {Ta Chuan} and Chao, {Tze Fan} and Te, {Abigail Louise D.} and Shinya Yamada and Ling Kuo and Vicera, {Jennifer Jeanne B.} and Chang, {Ting Yung} and Simon Salim and Huang, {Ting Chung} and Liu, {Chih Min} and Wu, {Cheng I.} and Chen, {Shih Ann}",

note = "Publisher Copyright: {\textcopyright} 2019, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2020",

month = apr,

day = "1",

doi = "10.1007/s10840-019-00512-3",

language = "English",

volume = "57",

pages = "353--359",

journal = "Journal of Interventional Cardiac Electrophysiology",

issn = "1383-875X",

publisher = "Springer Netherlands",

number = "3",

}

Lin, CY, Chung, FP, Lin, YJ, Chen, YY, Chang, SL , Lo, LW , Hu, YF, Liao, JN, Tuan, TC, Chao, TF, Te, ALD, Yamada, S, Kuo, L, Vicera, JJB, Chang, TY, Salim, S, Huang, TC, Liu, CM, Wu, CI & Chen, SA 2020, 'Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar', Journal of Interventional Cardiac Electrophysiology, 卷 57, 編號 3, 頁 353-359. https://doi.org/10.1007/s10840-019-00512-3

TY - JOUR

T1 - Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar

AU - Lin, Chin Yu

AU - Chung, Fa Po

AU - Lin, Yenn Jiang

AU - Chen, Yun Yu

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Liao, Jo Nan

AU - Tuan, Ta Chuan

AU - Chao, Tze Fan

AU - Te, Abigail Louise D.

AU - Yamada, Shinya

AU - Kuo, Ling

AU - Vicera, Jennifer Jeanne B.

AU - Chang, Ting Yung

AU - Salim, Simon

AU - Huang, Ting Chung

AU - Liu, Chih Min

AU - Wu, Cheng I.

AU - Chen, Shih Ann

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Purpose: The right ventricular (RV) septal unipolar voltage (UV) for predicting left ventricular (LV) septal scar wall thickness (WT) remains to be elucidated. Methods: From 2013 to 2015, data obtained from RV and LV electroanatomic maps of 28 patients (mean age, 53 ± 16 years; 19 men [67.9%]) with/without identified LV septal scars were reviewed. Patients with an RV septal scar were excluded (n = 90). Direct measurement of septal WT was conducted (mean distance, 10.4 ± 3.3 mm). Patients in group 1 had a normal LV substrate, while those in group 2 had an LV septal scar. Fisher’s linear discriminant formula was used to determine the dynamic UV criteria. Results: A total of 552 points were collected: 323 in 12 patients from group 1 and 229 in 16 patients from group 2. The UV of the RV septum is capable of identifying the opposite LV endocardial bipolar scar and is proportional to the WT of the interventricular septum. In the absence of an RV endocardial scar, the formula of “RV septal cut-off value = 0.736 × WT − 0.117 mV” has better sensitivity and specificity for predicting the LV septal scar (0.96 vs. 0.68 and 0.91 vs. 0.80, respectively) than the predefined fixed criteria of 8.3 mV with a net reclassification improvement of 25.7% (P < 0.001). Conclusions: The combined measurement of UV and WT is more sensitive than the predefined fixed UV criteria for defining deep scars.

AB - Purpose: The right ventricular (RV) septal unipolar voltage (UV) for predicting left ventricular (LV) septal scar wall thickness (WT) remains to be elucidated. Methods: From 2013 to 2015, data obtained from RV and LV electroanatomic maps of 28 patients (mean age, 53 ± 16 years; 19 men [67.9%]) with/without identified LV septal scars were reviewed. Patients with an RV septal scar were excluded (n = 90). Direct measurement of septal WT was conducted (mean distance, 10.4 ± 3.3 mm). Patients in group 1 had a normal LV substrate, while those in group 2 had an LV septal scar. Fisher’s linear discriminant formula was used to determine the dynamic UV criteria. Results: A total of 552 points were collected: 323 in 12 patients from group 1 and 229 in 16 patients from group 2. The UV of the RV septum is capable of identifying the opposite LV endocardial bipolar scar and is proportional to the WT of the interventricular septum. In the absence of an RV endocardial scar, the formula of “RV septal cut-off value = 0.736 × WT − 0.117 mV” has better sensitivity and specificity for predicting the LV septal scar (0.96 vs. 0.68 and 0.91 vs. 0.80, respectively) than the predefined fixed criteria of 8.3 mV with a net reclassification improvement of 25.7% (P < 0.001). Conclusions: The combined measurement of UV and WT is more sensitive than the predefined fixed UV criteria for defining deep scars.

KW - Fisher’s linear discriminant formula

KW - Septal scar

KW - Unipolar voltage

KW - Wall thickness

UR - http://www.scopus.com/inward/record.url?scp=85061000316&partnerID=8YFLogxK

U2 - 10.1007/s10840-019-00512-3

DO - 10.1007/s10840-019-00512-3

M3 - Article

C2 - 30694424

AN - SCOPUS:85061000316

SN - 1383-875X

VL - 57

SP - 353

EP - 359

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

IS - 3

ER -

Dynamic unipolar voltage criteria of right ventricular septum for identifying left ventricular septal scar

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