体表心电图P波形态对局灶性房性心动过速起源部位的预测价值  

The Value of P Wave Morphology on Surface Electrocardiogram in Predicting Origin of Focal Atrial Tachycardia

作　　者：韩秀[1] 赵春月[1] 苏琪[2] 

机构地区：[1]大连医科大学附属第一医院心内科,116011 [2]大连市中心医院心内科

出　　处：《心电学杂志》2011年第1期3-4,10,共3页Journal of Electrocardiology(China)

摘　　要：目的探讨体表心电图房性P波形态对局灶性房性心动过速的预测价值。方法选取52例均经射频导管消融（下称消融）治疗成功的房性心动过速患者房性心动过速发作时体表心电图房性P波，分析P波的形态特征及其与房性心动过速起源部位的关系。结果V1P波正相预测左心房起源房性心动过速的敏感性和特异性分别为82．4％和80．0％；而I和aVL P波负相预测左心房起源房性心动过速的敏感性分别为4617％和52．9％，特异性分别达100．0％和88.2％；V1P波负相预测右心房起源房性心动过速的敏感性和特异性分别为80．0％和100．0％。心电图与消融诊断房性心动过速起源的比较，差异无统计学意义（P〉0．05）。结论通过房性心动过速发作时的P波形态分析，可初步预测局灶性房性心动过速的起源部位，为消融术前准备及选择恰当的手术方式提供一定临床参考。Objective To explore the value of P wave morphology on ECG in predicting origin of local atrial tachycardia （AT）. Methods The P wave morphology on surface ECG recorded during AT were analyzed retrospectively in 52 patients with local AT that was successfully ablated. Results The sensitivity and specificity of positive P wave in lead V1 in identifying left AT were 82.4% and 80%, respectively. The sensitivity of negative P wave in lead I and aVL in identifying left AT were 46.7% and 52.9%, respectively, while the specificity was100.0% and 88.2%, respectively. The sensitivity and specificity of negative P wave in lead V1 in identifying right AT were 80.0% and 100.0%, respectively. Conclusion The origin of focal AT may be predicted by analyzing P wave morphology on ECG.

关 键 词：P波形态 局灶性 房性心动过速 导管消融 

分 类 号：R541.7[医药卫生—心血管疾病]