经食管电生理检查对儿童青少年室上性心动过速的诊断价值  

Diagnostic value of transesophageal electrophysiologic study in children and adolescents with paroxysmal supraventricular tachycardia

作　　者：杨燕秋 王新康[1,2] YANG Yanqiu;WANG Xinkang(Provincial Clinical Medical College,Fujian Medical University,Fuzhou Fujian 350001;Department of Electrocardiographic Diagnosis,Fujian Pro-vincial Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建福州350001 [2]福建省立医院心电诊断科,福建福州350001

出　　处：《实用心电学杂志》2022年第4期280-283,共4页Journal of Practical Electrocardiology

基　　金：国家自然科学基金资助项目(61971140);福建省卫生教育联合攻关项目(2019-WJ-18);福建省财政厅专项课题(闽财指【2020】822号)。

摘　　要：目的探讨经食管电生理检查(transesophageal electrophysiologic study,TEEPS)对儿童青少年阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)的诊断价值。方法回顾性分析156例因心悸怀疑PSVT行TEEPS的患儿心电图及电生理资料。比较TEEPS和体表心电图对PSVT的检出率,统计TEEPS相对于心内电生理检查(intracardiac electrophysiologic study,IEPS)的敏感性、特异性及准确率。结果有90例患儿通过TEEPS检出PSVT。TEEPS对PSVT的检出率显著高于体表心电图(57.69%vs.19.87%,χ^(2)=55.15,P<0.05)。以IEPS为金标准,TEEPS诊断PSVT的准确率为95.38%(62/65)。TEEPS诊断房室结折返性心动过速的敏感性、特异性分别为92.86%、100.00%;诊断房室折返性心动过速的敏感性、特异性分别为97.14%、93.33%;诊断房内折返性心动过速的敏感性、特异性均达100.00%。结论TEEPS对儿童青少年PSVT有一定的诊断价值,也能用于对其发生机制的判定。Objective To explore the diagnostic value of transesophageal electrophysiologic study(TEEPS)in children and adolescents with paroxysmal supraventricular tachycardia(PSVT).Methods We retrospectively analyzed the ECG and electrophysiological data of 156 children and adolescents with palpitation who had undergone TEEPS due to suspected PSVT.The detection rate of PSVT separately by using TEEPS and surface ECG was compared;the sensitivity,specificity and accuracy rate of TEEPS in contrast to intracardiac electrophysiologic study(IEPS)were statistically analyzed.Results PSVT is detected in 90 cases by TEEPS.The detection rate of PSVT by TEEPS is significantly higher than that by surface ECG(57.69%vs.19.87%,χ^(2)=55.15,P<0.05).With IEPS as the gold standard,the accuracy rate of TEEPS in diagnosing PSVT is 95.38%(62/65).The sensitivity and specificity of TEEPS in diagnosing atrioventricular nodal reentrant tachycardia is 92.86%and 100.00%,respectively;its sensitivity and specificity in diagnosing atrioventricular reentrant tachycardia is separately 97.14%and 93.33%;its sensitivity and specificity in diagnosing intra-atrial reentrant tachycardia both reach 100.00%.Conclusion TEEPS has a certain diagnostic value for screening PSVT and judging its mechanism among children and adolescents.

关 键 词：经食管电生理检查 心内电生理检查 阵发性室上性心动过速 儿童 青少年 

分 类 号：R541.71[医药卫生—心血管疾病]