新旧流出道室性心律失常心电图定位方法比较  

Comparison of new and old electrocardiographic algorithms of location diagnosis for outflow tract ventricular arrhythmias

作　　者：杜志君[1] 王月刚[1] 蔡伟文[1] 张文静[1] 查道刚[1] 

机构地区：[1]南方医科大学附属南方医院心内科,广州市510515

出　　处：《实用医学杂志》2015年第22期3720-3723,共4页The Journal of Practical Medicine

摘　　要：目的:比较新流出道室性心律失常心电图定位方法与旧方法的准确性。方法:搜集2010-2013年南方医院202例消融手术成功流出道室性心律失常患者的病例资料,分析其移行区指数、V2移行指数、R波时限指数与振幅指数、Sv2/Rv3指数。结果:不考虑心脏转位,V2移行指数敏感性最高(93.5%),Sv2/Rv3指数特异性最高(93.8%),ROC曲线下面积分析四者均>0.8,移行区指数最小(0.804),有统计学意义(P﹤0.001)。心脏转位病例中,V2移行指数敏感性最高(93.9%),Sv2/Rv3指数特异性最高(94.7%),ROC曲线下面积四者均>0.8,两两比较差异无统计学意义(P>0.05)。结论:无论有无转位,Sv2/Rv3指数法均有较高的特异性及诊断价值,且和V2移行指数及R波时限指数与振幅指数诊断价值相当。Sv2/Rv3指数与其余方法相比,简洁明了,可互相补充用于指导射频消融手术。Objective To evaluate the accuracy of the new and old electrocardiographic algorithms for differentiating the origins of outflow tract ventricular arrhythmias. Methods The clinical data of 202 patients treated between 2010 and 2013 were retrospectively reviewed for the investigations of the four algorithms including the transitional zone index, the V2 transition ratio, V2 R-wave duration and R/S-wave amplitude indices and the Sv2/Rv3 index. Results Regardless of rotation, the Vz transition ratio had the highest sensitivity （93.5%）, while the Sv2/Rv3 index had the highest specificity （93.8）. The maximal area under the ROC curve of four was more than 0.8, while the transitional zone index had the minimal area （0.804） with statistical significance （P 〈 0.001 ）. In the patients with precordial transition, the V2 transition ratio had the highest sensitivity （93.9%）, while the Sv2/Rv3 index had the highest specificity （94.7%）. The maximal area under the ROC curve of four was more than 0.8 with no statistical significance （P 〉 0.05）. Conclusion Regardless of rotation, the Sv2/Rv3 index has the highest specificity and equal diagnostic value, with equal diagnostic value of the V2 transition ratio and V2 R-wave duration and R/S-wave amplitude indices. Compared with other algorithms, the SvE/RV3 index is simple and can be a complement as well for the direction of ablation therapy.

关 键 词：室性早搏 室性心动过速 心电图 导管消融 

分 类 号：R541.7[医药卫生—心血管疾病]