经食管心房调搏对隐匿性房室旁道的定位诊断价值  

Diagnosis and analysis of localization characteristics of transesophagel atrial pacing in concealed accessory atrioventricular pathway

作　　者：彭伟华[1] 韩宏伟[1] 王三娣[1] 尚小珂[1] 闻捷[1] 彭婷[1] 

机构地区：[1]武汉亚洲心脏病医院心血管外科,湖北武汉430022

出　　处：《心脏杂志》2014年第1期60-63,共4页Chinese Heart Journal

摘　　要：目的:探讨经食管心房调搏对隐匿性房室旁道的诊断和定位特征。方法:回顾分析360例经心内电生理检查确诊为隐匿性房室旁道患者,总结其经食管心房调搏的特征表现。结果:Ⅰ导联P'倒置定位诊断左侧旁道的灵敏度为69%,特异度为98%;V1导联P'波直立定位诊断左侧旁道的灵敏度为71%,特异度为88%,V1导联P'双向定位诊断左侧旁道的灵敏度为14%,其特异度为95%,RP'E<RP'V1诊断左侧旁道的灵敏度为82%,特异度为99%。Ⅰ导联P'直立诊断右侧旁道的灵敏度为75%,特异度为93%,V1导联P'倒置诊断右侧旁道的灵敏度为65%,特异度为99%,RP'E>RP'V1诊断右侧旁道的灵敏度为82%,特异度为100%。结论:分析Ⅰ、V1导联P'特点和测量对比RP'E及RP'V1对隐匿性旁道诊断和粗略左右旁道定位具有重要价值。AIM： To investigate diagnosis and analysis of localization characteristics of transesophaged atrial pacing in concealed accessory atrioventricular pathway. METHODS： We retrospectively analyzed 360 cases of concealed accessory atfioventricular pathway, which were diagnosed by intracardiac electro- physiology and concluded their characteristic manifestation transesophaged atrical pacing. RESULTS： The sensitivity of inverted P＇ wave in lead I in the diagnosis of left-sided accessory pathways was 69% , and the specificity was 98% , The sensitivity of upright P ＇-wave in lead V1 in the diagnosis of left-sided accessory pathways was 71%, and the specificity was 88%. The sensitivity of bidirectional P＇ wave in V1 lead in the diagnosis of left-sided accessory pathways was 14%. Specificity was 95%, sensitivity of RP＇E 〈 RP＇w in the diagnosis of left-sided accessory pathways was 82% , and the specificity was 99%. The sensitivity of upright P＇ wave in lead I in the diagnosis of right-sided accessory pathways was 75%, and the specificity was 93% , The sensitivity of inverted P＇ wave in lead V1 in the diagnosis of fight-sided accessory pathways was 65%, and the specificity was 99%. The sensitivity of RP＇s 〉 RP＇v1 in the diag- nosis of right-sided accessory pathway was 82% , and the specificity was 100%. CONCLUSION： Ana- lyses of the P＇ wave characteristics in lead I and V1 and measuring or contrasting RP＇E and RP＇v1 has a significant value of diagnosis and localization of concealed accessory atrioventricular pathway.

关 键 词：房室旁道 隐匿性 经食管心房调搏 心内电生理检查 

分 类 号：R541.7[医药卫生—心血管疾病] R445.1[医药卫生—内科学]