QSaVR/aVL对胸前V3导联移行流出道室性心律失常起源部位的鉴别价值OA

Aim:To explore the value of lead aVR and aVL QS wave amplitude ratio(QSaVR/aVL)in identifying ori-gin of outflow tract ventricular arrhythmia(OT-VA)with precordial R/S transition at lead V3.Methods:This study enrolled 102 OT-VA patients with precordial R/S transition at lead V3 who underwent successful radiofrequency catheter ablation in the First Affiliated Hospital of Zhengzhou University between January 2018 and February 2025.The origin sites of 86 pa-tients were RVOT(RVOT group)and those of 16 patients were LVOT(LVOT group).The lead aVR and aVL QS wave am-plitude(QSaVR and QSaVL)in t23he surface electrocardiogram were measured during OT-VA,and QSaVR/aVL was calcu-lated.ROC curves were plotted to assess the diagnostic performance of QSaVR,QSaVL,and QSaVR/aVL in identifying origin of outflow tract ventricular arrhythmias.Results:There was no significant difference in QSaVR between the 2 groups(P=0.303),QSaVL was significantly lower in RVOT group than that in LVOT group,and QSaVR/aVL was significantly higher in RVOT group than that in LVOT group(P<0.05).QSaVR/aVL had the largest AUC for identifying RVOT origin and the AUC(95％CI)was 0.929(0.875-0.983).When QSaVR/aVL>1.0 was applied to identify RVOT origin,the sensitivity,specificity and accuracy were 0.919,0.813 and 0.902,respectively.Conclusion:QSaVR/aVL>1.0 could be applied to i-dentify RVOT originating OT-VA with precordial R/S transition at lead V3 accurately.