Predicting value of coupling interval variability in determining the origin of ventricular premature contractions with V3 transition

  • Umut CelikyurtEmail author
  • Aysen Agir
  • Irem Karauzum
  • Kurtulus Karauzum
  • Tayfun Sahin
  • Ahmet Vural



We aimed to investigate the predictive value of coupling interval variability (ΔCI) in determining the origin of idiopathic outflow tract ventricular tachycardia (OTVT) with V3 transition.


We reviewed data from 126 patients who underwent catheter ablation of OTVT between 2015 and 2018 at our institution. We identified 32 patients of successful OTVT ablation with a precordial transition at V3 derivation. The ΔCI (maximum − minimum CI) was measured.


CI variability was significantly smaller for right ventricular (RV) OT than left ventricular  (LV) OT premature ventricular contractions (PVCs) (p = 0.004). In multivariate analysis, including QRS duration, R-wave duration in lead V1, R-wave amplitude in V1, PVC burden, and ΔCI, ΔCI was the only independent predictor of PVC origin (OR 0.963, 95% CI, 0.939–0.988, p < 0.001). A CI variability ≥ 30 predicted a PVC from LVOT origin with a sensitivity of 83% and specificity of 89%. ΔCI was compared with other previously proposed ECG criteria used to differentiate LVOT from RVOT PVCs. ΔCI exhibited a greater area under the curve (AUC) (0.867) than the other ECG criteria. A ΔCI ≥ 30 ms exhibited a high sensitivity of 89% and a specificity of 83%.


ΔCI is outperformed other ECG criteria to differentiate LVOT from RVOT PVCs, and this parameter may be useful for planning the ablation strategy.


Premature ventricular contractions Coupling interval Electrocardiogram V3 transition 


Compliance with ethical standards

The study was approved by the Local Ethical Committee.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Umut Celikyurt
    • 1
    • 2
    Email author
  • Aysen Agir
    • 1
  • Irem Karauzum
    • 1
  • Kurtulus Karauzum
    • 1
  • Tayfun Sahin
    • 1
  • Ahmet Vural
    • 1
  1. 1.Department of CardiologyKocaeli University Medical FacultyKocaeliTurkey
  2. 2.Department of CardiologyKocaeli University Medical Faculty, UmuttepeKocaeliTurkey

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