体表与食管心电图RP^-间期在阵发性室上性心动过速鉴别诊断中的价值  

The value of RP^- interval on surface and esophageal electrocardiogram in differential diagnosis of paroxysmal supraventricular tachycardia

作　　者：吴浩 厉剑 吴敏[2] 刘星 高洁 谢玮 WU Hao;LI Jian;WU Min(Department of Electrocardiogram,Hangzhou First People’s Hospital,Medical College of Zhejiang University,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院心电功能科,310006 [2]杭州市第七人民医院特检科

出　　处：《心电与循环》2019年第5期385-388,394,共5页Journal of Electrocardiology and Circulation

基　　金：杭州市农业与社会发展科研项目(20191203B86)

摘　　要：目的探讨体表与食管心电图RP-间期对不同类型阵发性室上性心动过速(PSVT)的诊断价值。方法选取2015年1月至2018年12月行射频导管消融(简称消融)术治疗的慢-快型房室结折返性心动过速(AVNRT)患者262例和顺向型房室折返性心动过速(OAVRT)患者285例,分析体表心电图V1和食管双极导管心电图V1RP-间期值和EBRP-间期诊断两种类型PSVT的灵敏度、特异度、最佳临界值。结果多因素logistic回归分析显示年龄、V1RP-间期值和EBRP-间期值是判断不同类型PSVT的参数,对于判断慢-快型AVNRT,年龄的OR(95%CI)为1.033(1.007-1.060),V1RP-间期值的OR(95%CI)为0.908(0.884-0.934),EBRP-间期值的OR(95%CI)为0.916(0.890-0.943)。年龄、V1RP-间期值、EBRP-间期值对诊断慢-快型AVNRT的受试者工作特征(ROC)曲线下面积(AUC)分别为0.60、0.98、0.97。后两者诊断慢-快型AVNRT的最优切点分别为<90ms和<80ms。结论EBRP-间期和V1RP-间期有助于PSVT的鉴别诊断。Objective To investigate the value of RP-interval on surface electrocardiogram(ECG) and esophageal ECG in differential diagnosis of paroxysmal supraventricular tachycardia(PSVT).Methods 262 patients with slow-fast AVNRT and 285 patients with orthodromic AVRT treated with radiofrequency ablation from January 2015 to December 2018 were analyzed. The sensitivity,specificity and cutpoint of RP-interval on surface V1 lead(V1 RP-interval) and esophageal bipolar lead(EB RP-interval) ECG in diagnosis of the two types of PSVT were determined.Results Multivariate logistic regression analysis showed that age,V1 RP-interval and EB RP-interval were the parameters for differentiating different types of PSVT. For slow-fast AVNRT,the OR of age,V1 RP-interval and EB RP-interval were 1.033 (1.007-1.060),0.908(0.884-0.934) and 0.916(0.890-0.943),respectively. The area under the receiver operating characteristic curves of Age,V1 RP-interval value and EB RP-interval value in diagnosis of slow-fast AVNRT were 0.60,0.98 and 0.97,respectively. The optimal cutpoint of latter parameters was <80ms and <90ms,respectively.Conclusion V1 RP-interval and EB RP-interval are helpful in differentiate diagnosis of PSVT.

关 键 词：阵发性室上性心动过速 V1RP-间期 EB RP-间期 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]