一种新的预定位法鉴别宽QRS波群节律的可行性研究  

Study on the feasibility of identifying wide QRS rhythms by a new pre-localization method

作　　者：倪红林 王志勇 潘筱蔚 徐丽芳 朱建芳 NI Honglin;WANG Zhiyong;PAN Xiaowei;XU Lifang;ZHU Jianfang(Department of Electrocardiography,Jiaxing First Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市第一医院心电科,314000

出　　处：《心电与循环》2024年第1期35-38,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨一种新的理论推演的宽QRS波群节律鉴别方法(下称预定位法)运用的可行性。方法运用预定位法、Griffith法、aVR法回顾性分析2018年1月至2022年9月嘉兴市第一医院收治的372例患者的常规心电图宽QRS波群,与心内三维电解剖标测系统(CARTO)标测结果对比,比较3种方法诊断室性心律失常(VA)的灵敏度、特异度、准确度。通过与CARTO标测的结果对比,确定预定位法4步流程预判VA心室起源部位的灵敏度和特异度。结果预定位法诊断VA的灵敏度、特异度、准确度均高于Griffith法、aVR法(0.98比0.87比0.80、0.85比0.65比0.72、0.94比0.81比0.78),差异均有统计学意义(均P<0.05)。预定位法4步流程预判VA心室起源部位的灵敏度分别为0.99、1.00、1.00、0.96,特异度分别为0.96、1.00、1.00、0.99。结论预定位法适用于鉴别宽QRS波群节律的起源部位。Objective To study the feasibility of a new theoretical method for identifying wide QRS rhythms(hereinafter referred as pre-localization method).Methods The wide QRS complex of 372 cases from January 2018 to September 2022 in Jiaxing First Hospital on routine ECG were retrospectively analyzed by pre-localization method,Griffith method and aVR method,and the diagnostic results were compared with those of intracardiac three-dimensional mapping system(CARTO).The sensitivity,specificity and accuracy of the three methods in the diagnosis of ventricular arrhythmias(VA)were compared.The sensitivity and specificity of the four-step procedure of the pre-localization method for identifying VA origin sites were determined by compared to CARTO mapping.Results The sensitivity,specificity and accuracy of the pre-localization method for the diagnosis of VA were higher than those of Griffith method and aVR method(0.98 vs.0.87 vs.0.80,0.85 vs.0.65 vs.0.72,0.94 vs.0.81 vs.0.78),the differences were statistically significant(all P<0.05).The sensitivity and specificity of the four-step procedure for predicting ventricular origin site of VA were 0.99,1.00,1.00 and 0.96,respectively,and the specificity were 0.96,1.00,1.00 and 0.99,respectively.Conclusion The pre-localization method is suitable for identifying origin site of wide QRS rhythms.

关 键 词：宽QRS波群节律 起源部位 定位 

分 类 号：R541.7[医药卫生—心血管疾病]