右室流出道起源与主动脉窦起源室性早搏的分析

Analysts differentiation of premature ventricular between right ventricular outflow tract and aortic sinus cusp

目的 探讨右室流出道起源与主动脉窦起源室性早搏心电图的主要区别.方法 回顾分析因频发室性早搏,心电图室性早搏胸前导联呈左束支传导阻滞,Ⅱ、Ⅲ、aVF导联QRS主波向上,行射频消融成功的患者126例,分为右室流出道（RVOT）起源组66例,主动脉窦（ASC）起源组60例.结果 V1、V2导联R波时限指数和R/S波幅指数ASC组高于RVOT组.胸前导联移行区指数RVOT组高于ASC组.ROC曲线分析胸前导联移行区指数鉴别室性早搏起源有较高价值.结论 心电图呈左束支传导阻滞且Ⅱ、Ⅲ、aVF导联QRS主波向上的室性早搏,分析V1、V2导联R波时限指数、R/S波幅指数和胸前导联移行区指数可判断RVOT起源与ASC起源,指导射频消融治疗.

Objective To investigate the main ECG differentiation of premature ventricular contraction between right ventricular outflow tract（RVOT） and aortic sinus cusp（ASC）.Methods Suffaee ECG s of premature ventricular contraction with left bundle branch block morphology in precordial leads and upwards QRS main wave in leads Ⅱ,Ⅲ and aVF in 126 patients who were successfully ablated in the RVOT （n=66） or the ASC （n=60）were retrospectively analyzed.Results The indexes of R-wave duration and R/S-wave amplitude were significantly higher in ASC group than in RVOT group.The precordial transition zone index was significantly higher in the RVOT group than in the ASC group.ROC curve analysis precordial transition zone index to identify premature ventricular contraction origin have higher value.Conclusion The indexes of R-wave duration and R/S-wave amplitude and the precordial transition zone index can be used to differentiate premature ventricular contraction origin between RVOT and ASC and guide radiofrequency ablation.