aVR导联法在儿童室性心动过速鉴别诊断中的价值

Value of single aVR lead in differential diagnosis of ventricular tachycardia in children

目的探讨aVR单导联方法在鉴别儿童室性心动过速中的应用价值。方法对47例已经经电生理检测明确诊断的儿童宽QRS心动过速心电图(41例室性心动过速,6例为非室性心动过速),运用aVR单导联方法进行回顾性分析,计算每一步的正确诊断率,及其总的准确性、灵敏度、特异度。结果 aVR导联对儿童宽QRS心动过速的正确诊断率为79%、灵敏度81%、特异度70%,阳性预测值91%,阴性预测值50%。9例儿童室性心动过速误诊为非室性心动过速,1例室上性心动过速误诊为室速。结论 aVR单导联方法可用于儿童室性心动过速鉴别诊断,由于其简单易行,更适用于急诊病例。

Objective To examine the diagnostic value of single lead aVR method in wide QRS ventricular tachycardia （VT） in children. Methods The single lead aVR method was used to analyze wide QRS taehycardia diagnosed by ECGs in 47 patients. Then from comparison with the eloctrophysiological results the sensitivity, specificity and diagnostic accordance rate in each step of the VT diagnosis process were calculated. Results The sensitivity, specificity, diagnostic concordance rate, positive predictive value and negative predictive value of single lead aVR method in diagnosis of wide QRS complex VT were 81%, 70%, 78%, 91% and 50%. Nine VT cases were mis-diagnosed as non-ventricular and one SVT case was mis-diagnosed as VT. Conclusions The single aVR lead can be used in differential diagnosis of VT in children. Because of its simple and time-saving features, it has a high clinical value, especially forthe emergency department.