Validation of a clinical model for predicting left versus right ventricular outflow tract origin of idiopathic ventricular arrhythmias.

Bourquin, Luc; Küffer, Thomas; Asatryan, Babken; Badertscher, Patrick; Baldinger, Samuel H; Knecht, Sven; Seiler, Jens; Spies, Florian; Servatius, Helge; Kühne, Michael; Noti, Fabian; Osswald, Stefan; Haeberlin, Andreas; Tanner, Hildegard; Roten, Laurent; Reichlin, Tobias; Sticherling, Christian (2023). Validation of a clinical model for predicting left versus right ventricular outflow tract origin of idiopathic ventricular arrhythmias. Pacing and clinical electrophysiology, 46(10), pp. 1186-1196. Wiley 10.1111/pace.14809

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Prediction of the chamber of origin in patients with outflow tract ventricular arrhythmias (OTVA) remains challenging. A clinical risk score based on age, sex and presence of hypertension was associated with a left ventricular outflow tract (LVOT) origin. We aimed to validate this clinical score to predict an LVOT origin in patients with OTVA.


In a two-center observational cohort study, unselected patients undergoing catheter ablation (CA) for OTVA were enrolled. All procedures were performed using an electroanatomical mapping system. Successful ablation was defined as a ≥80% reduction of the initial overall PVC burden after 3 months of follow-up. Patients with unsuccessful ablation were excluded from this analysis.


We included 187 consecutive patients with successful CA of idiopathic OTVA. Mean age was 52 ± 15 years, 102 patients (55%) were female, and 74 (40%) suffered from hypertension. A LVOT origin was found in 64 patients (34%). A score incorporating age, sex and presence of hypertension reached 73% sensitivity and 67% specificity for a low (0-1) and high (2-3) score, to predict an LVOT origin. The combination of one ECG algorithm (V2 S/V3 R-index) with the clinical score resulted in a sensitivity and specificity of 81% and 70% for PVCs with R/S transition at V3 .


The published clinical score yielded a lower sensitivity and specificity in our cohort. However, for PVCs with R/S transition at V3, the combination with an existing ECG algorithm can improve the predictability of LVOT origin.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Kueffer, Thomas, Asatryan, Babken, Baldinger, Samuel Hannes, Seiler, Jens, Servatius, Helge Simon (B), Noti, Fabian, Häberlin, Andreas David Heinrich, Tanner, Hildegard, Roten, Laurent, Reichlin, Tobias Roman


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

25 Aug 2023 12:57

Last Modified:

11 Oct 2023 00:15

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

ablation outflow tract tachycardia premature ventricular complex ventricular tachycardia




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