头胸导联与常规导联心电图对显性旁路定位诊断的比较

Comparison between the head-chest leads electrocardiogram and routine leads in the manifest accessory pathways in patients with Wolff-Parkinson-White syndrome

目的观察在对预激综合征患者显性旁路定位诊断方面,头胸导联心电图是否具有与常规导联心电图一样的价值。方法对于按标准预先筛选的预激综合征患者,同时记录常规心电图及头胸导联心电图各1份,由两位资深的电生理医生进行分析,对旁路作出定位诊断。而后由观察者将两种导联心电图的诊断结果与心内电生理检查的结果相对照,计算出两种导联心电图对旁路定位的准确率,并作χ2检验,同时对两种导联心电图Δ波的大小进行比较。结果本实验包括由全国12家大医院提供的符合入选标准的预激综合征患者58例。常规导联心电图的诊断准确率是86.2%(50/58),头胸导联心电图的准确率是84.4%(49/58),两者无统计学上的差异(P>0.05);头胸导联记录的Δ波都比对应常规导联的更为明显。结论在对预激综合征患者显性旁路定位诊断方面,头胸导联心电图与常规心电图一样都具有较高的准确率。

Objective To observe whether there was difference between the head-chest leads electrocardiogram （HCECGs） and routine lead electrocardiogram （RLECGs） in the manifest accessory pathways in patients with Wolff-Parkinson-White syndrome. Methods HCECGs and RLECGs were recorded simultaneously in patients with Wolff-Parkinson-White syndrome, whose manifest accessory pathways had been confirmed by radiofrequency catheter ablation and intra-cardiac electrophysiology according to the same standard set beforehand. The diagnosis of pathways location was made by analysis of each HCECG and RLECG by two senior physicians in clinical electrophysioiogy. The diagnostic accuracy of the HCECGs and. RLECGs was evaluated by the comparison with that of the intra-cardiac electrophysiology. The delta wave size was also compared between HCECGs and RLECGs. Results The diagnostic accuracy in the manifest accessory pathways was 86.2% （50/58） in RLECGs, and 84.4% （49/58） in HCECGs in the 58 patients with Wolff-Parkinson-White syndrome, showing no significant difference between them （P〉0.05）, but each delta wave in HCECG was more evident than that in RLECG. Conclusion HCECG and RLECG both have high diagnostic accuracy in the manifest accessory pathways in patients with Wolff-Parkinson-White syndrome.