房室旁束心电图定位的规则系统  

An Algorithm for the Electrocardiographic Localization of Atrioventricular Accessory Pathway REN

作　　者：任在镐[1] 王建安[1] 陈君柱[1] 陈鹏[2] 许春萱[3] 胡大一[4] 

机构地区：[1]浙江大学医学院附属第二医院心内科,浙江大学医学院附属第一医院心内科,310009 [2]浙江大学医学院附属第一医院国际体检保健中心 [3]福建省心血管病研究所 [4]北京大学人民医院心脏中心

出　　处：《心电学杂志》2011年第4期297-305,共9页Journal of Electrocardiology(China)

摘　　要：目的 研究房室旁束心电图定位的新规则系统.方法 将全心分为10个区域,每区样本26～64例,累积射频导管消融成功的单支房室旁束358例.采用δ波初始20ms极性、QRS形态、R / S比值和QRS终末波极性等作为该规则系统的定位指标.结果 本规则系统对单支房室旁束定位的敏感度为90.2%,特异度97.3%,定位正确率96.6%.结论 90%以上的房室旁束可通过本规则系统从6道同步体表心电图作出正确定位.提高定位正确率的关键是必须重视心电图记录质量,消除干扰,保持基线平稳.Objective The purpose of the present study was to develop a new stepwise algorithm for the electrocar-diographic localization of atrioventricular accessory pathway. Methods The whole heart was divided into 10 areas. The sample contained 26-64 cases in each area. Totally 358 cases of single accessory pathway who successfully underwent radiofrequency catheter ablation were included. Polarity of initial 20ms 6 ware,configuration of QRS complex,R/S ratio and polarity of terminal wave of the QRS complex were employed as localization index of the ECG algorithm. Results The sensitivity, specificity and accuracy of this algorithm in localize single A-V accessory pathway were 90.2%,97.3% and 96.6% ,respectively. Conclusion Over 90% correct localization of single A-V accessory pathway from 6-syn- chronous-lead surface electrocardiogram could be achieved with this algorithm. The key facts of raising the accuracy of localization was to improve the quality of electrocardiographic record, mark great efforts,eliminate interference and keep smooth baseline.

关 键 词：预激综合征 房室旁束 定位 心电图规则系统 射频导管消融 

分 类 号：R541.77[医药卫生—心血管疾病]