经体表心电图的旁路定位与心内电生理检查结果的对比分析  

The analysis of accessory pathway location by surface electrocardiogram and electrophysiologic study in the patients with pre-excitation syndrome

作　　者：王小青[1] 惠杰[1] 杨向军[1] 宋建平[1] 蒋庭波[1] 李勋[1] 刘志华[1] 蒋文平[1] 

机构地区：[1]苏州大学附属第一医院心内科,215006

出　　处：《临床心电学杂志》2007年第2期109-111,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨体表心电图对预激综合征患者旁路定位的价值及定位程序。方法对预激综合征合并阵发性室上速而入院行射频消融术的47例患者进行回顾性分析,分析术前V1导联QRS特征及相关导联预激波极性等参数,对照腔内电生理检查结果,观察心电图定位的敏感性和特异性。结果①V1导联R/S>1者提示左侧旁路,其敏感性和特异性分别为88.9%、94.7%。V1导联R/S<1者提示右侧旁路,其敏感性和特异性分别为95%、90.5%。②δaVF极性对左右旁路前后位置的定位均有意义。③δI极性对左侧旁路的定位有参考价值,各组间有显著差异性(p<0.01);对右侧旁路无统计学意义(p>0.05)。④胸导联R/S移行区在V1、V2间对判定间隔部旁路有意义。结论体表心电图旁路定位可靠,具有较好的准确性及实用价值。Objective To evaluate the value of accessory pathway （AP） location by surface electrocardigram （ECG）. Method 47 patients with WPW syndrome underwnt radiofrequence catheter ablation （RFCA）. By analyzing the character of V1 lead and other parameters such as pre-excitation wave polarity of correlated leads and comparing with the result of EPS, to observation the sensitivity and specificity of the method by surface ECG. Results （1）R/S〉1 means left AP, its sensitivity and specificity are 88.9%,94.7%. R/S〈1 means right AP, its sensitivity and specificity are 95% ,90.5%. （2）the polarity of δAVF senses for AP location of both sides. （3）R/S transition zones in V1, V2 lead senses for interval parts, but it is hard to decide which side. Conclusion To locate AP by surface ECG has good accuration and practical value in the patients with WPW syndrome.

关 键 词：预激综合征 旁路定位 体表心电图 电生理检查 

分 类 号：R540.4[医药卫生—心血管疾病]