A Hybrid Score to Predict the Origin of Outflow Tract Ventricular Arrhythmias in Patients with Conduction Disorders or Paced Rhythm

What this Trial Is About

This research aims to evaluate a hybrid scoring system designed to predict the origin site of outflow tract ventricular arrhythmias (OTVA) in patients who have wide basal QRS complexes due to intraventricular conduction defects or paced rhythms. Accurately determining the origin of OTVA is important for guiding catheter ablation, which is the main treatment for symptomatic OTVA, helping to reduce risks and improve success. Previous studies excluded patients with structural heart disease or paced rhythms, but this study includes them to better assess the hybrid score's effectiveness. The study uses a hybrid score combining clinical data (age over 50, male sex, presence of arterial hypertension) and ECG features related to QRS transition points to distinguish between right ventricular outflow tract (RVOT) and left ventricular outflow tract (LVOT) origins. ECGs are recorded with standard settings, and activation mapping during spontaneous OTVA is performed to identify the ablation site. Patients are grouped based on whether their arrhythmia originates in the RVOT or LVOT. Participants provide consent and submit demographic, medical history, ECG, and echocardiographic data. The catheter ablation procedure is monitored collecting data on radiofrequency applications, procedure times, and mapping points. The main outcome measured is the hybrid score's predictive performance at the time of the procedure, with safety assessed one month afterward. Adverse events are tracked, and comprehensive clinical and procedural information is gathered to support the evaluation.

Hybrid Score to Predict OTVA-SOO in Patients with Wide Basal QRS