Abstract
Since Einthoven invented the string galvanometer for registering electrical activity of the heart in 1903, electrocardiography (ECG) became the most common and important medical examination. With this 12-lead surface ECG, we can diagnose arrhythmia, ischemic heart disease, or other heart disease.
Electrophysiologic study (EPS) has increased our understanding about the mechanism of arrhythmias, including atrioventricular nodal reentry tachycardia (AVNRT), atrioventricular reentry tachycardia (AVRT), atrial tachycardia (AT), and ventricular tachycardia (VT). Catheter ablation using radiofrequency energy has become the treatment of choice for most supraventricular tachycardia (SVT) and VT. Precise review of 12-lead surface ECG can give us the cause of SVT and location of accessory pathway (AP) and focal site of monomorphic VT. So we can plan the ablation technique and reduce the procedure time.
We are going to see the usefulness of 12-lead surface ECG for EPS, especially in the era of radiofrequency catheter ablation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Porter MJ, Morton JB, Denman R, et al. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm. 2004;1:397–8.
ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias). Circulation. 2003;108:1871–909.
Gonz´alez-Torrecilla E, Almendral J, Arenal A, et al. Independent predictive accuracy of classical electrocardiographic criteria in the diagnosis of paroxysmal atrioventricular reciprocating tachycardias in patients without preexcitation. Europace. 2008;10:624–8.
Kalbfleisch SJ, El-Atassi R, Calkins H, et al. Differentiation of paroxysmal narrow QRS complex tachycardias using the 12-lead electrocardiogram. J Am Coll Cardiol. 1993;21:85–9.
Riva SI, Della Bella P, Fassini G, Carbucicchio C, Tondo C. Value of analysis of ST segment changes during tachycardia in determining type of narrow QRS complex tachycardia. J Am Coll Cardiol. 1996;27(6):1480.
Scheinman MM, Wang YS, Van Hare GF, Lesh MD. Electrocardiographic and electrophysiologic characteristics of anterior, midseptal and right anterior free wall accessory pathways. J Am Coll Cardiol. 1992;20(5):1220.
Rostock T, Sydow K, Steven D, Lutomsky B, Servatius H, Drewitz I, Falke V, Müllerleile K, Ventura R, Meinertz T, Willems S. A new algorithm for concealed accessory pathway localization using T-wave-subtracted retrograde P-wave polarity during orthodromic atrioventricular reentrant tachycardia. J Interv Card Electrophysiol. 2008;22(1):55–63.
Chiang CE, Chen SA, Teo WS, Tsai DS, Wu TJ, Cheng CC, Chiou CW, Tai CT, Lee SH, Chen CY, et al. An accurate stepwise electrocardiographic algorithm for localization of accessory pathways in patients with Wolff-Parkinson-White syndrome from a comprehensive analysis of delta waves and R/S ratio during sinus rhythm. Am J Cardiol. 1995;76(1):40–6.
Fitzpatrick AP, Gonzales RP, Lesh MD, Modin GW, Lee RJ, Scheinman MM. New algorithm for the localization of accessory atrioventricular connections using a baseline electrocardiogram. J Am Coll Cardiol. 1994;23(1):107–16.
Xie B, Heald SC, Bashir Y, Katritsis D, Murgatroyd FD, Camm AJ, Rowland E, Ward DE. Localization of accessory pathways from the 12-lead electrocardiogram using a new algorithm. Am J Cardiol. 1994;74(2):161–5.
Katsouras CS, Greakas GF, Goudevenos JA, Michalis LK, Kolettis T, Economides C, Argyri U, Pappas S, Sideris DA. Localization of accessory pathways by the electrocardiogram: which is the degree of accordance of three algorithms in use? Pacing Clin Electrophysiol. 2004;27(2):189–93.
Arruda MS, McClelland JH, Wang X, et al. Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome. J Cardiovasc Electrophysiol 1998;9:2–12.
Kistler PM, Roberts-Thomson KC, Haqqani HM, Fynn SP, Singarayar S, Vohra JK, Morton JB, Sparks PB, Kalman JM. P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin. J Am Coll Cardiol. 2006;48(5):1010.
Haqqani HM, Morton JB, Kalman JM. Using the 12-lead ECG to localize the origin of atrial and ventricular tachycardias: part 2–ventricular tachycardia. J Cardiovasc Electrophysiol. 2009;20(7): 825–32.
Dixit S, Gerstenfeld EP, Callans DJ, Marchlinski FE. Electrocardiographic patterns of superior right ventricular outflow tract tachycardias: distinguishing septal and free-wall sites of origin. J Cardiovasc Electrophysiol. 2003;14(1):1–7.
Jadonath RL, Schwartzman DS, Preminger MW, Gottlieb CD, Marchlinski FE. Utility of the 12-lead electrocardiogram in localizing the origin of right ventricular outflow tract tachycardia. Am Heart J. 1995;130(5):1107–13.
Callans DJ, Menz V, Schwartzman D, Gottlieb CD, Marchlinski FE. Repetitive monomorphic tachycardia from the left ventricular outflow tract: electrocardiographic patterns consistent with a left ventricular site of origin. J Am Coll Cardiol. 1997;29(5):1023–7.
Dixit S, Gerstenfeld EP, Lin D, Callans DJ, Hsia HH, Nayak HM, Zado E, Marchlinski FE. Identification of distinct electrocardiographic patterns from the basal left ventricle: distinguishing medial and lateral sites of origin in patients with idiopathic ventricular tachycardia. Heart Rhythm. 2005;2(5):485–91.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag London
About this chapter
Cite this chapter
Bae, JH., Kwon, TG., Kim, KH. (2014). The Clinical Utility of 12-Lead Resting ECG in the Era of Ablation Strategies. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_11
Download citation
DOI: https://doi.org/10.1007/978-1-4471-5316-0_11
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-5315-3
Online ISBN: 978-1-4471-5316-0
eBook Packages: MedicineMedicine (R0)