摘要
目的探究avR导联在阵发性室上性心动过速(PSVT)中的鉴别诊断价值。方法选取行射频消融的患者150例,分为房室折返性心动过速组(AVRT组n=82)和房室结折返性心动过速组(AVNRT组n=68),观察窦性心律及室上速发作时avR导联QRS波终末部形态(假r波或粗顿)和ST段抬高(水平型,上斜型,及下斜型)改变情况。结果与窦性心律相比,AVRT组avR导联QRS波终末部形态改变共5例(6.0%),AVNRT组avR导联QRS波终末部形态改变有50例(73.5%),差异有统计学意义(P<0.05),其诊断AVNRT的敏感性、特异性和阳性预测值分别是72.0%、82.4%、83.1%;与窦性心律时相比,AVRT组avR导联ST段抬高的发生数为59例,AVNRT组avR导联ST段抬高的有12例,差异有统计学意义(P<0.05),其诊断AVRT的敏感性、特异性和阳性预测值分别是73.5%、94.0%、91.0%。结论与窦性心律相比,avR导联假性r波或粗顿以及ST段抬高对判断PSVT的类型具有重要意义,有助于PSVT的鉴别诊断价值。
Objective To evaluate the pseudo-r' or notching and ST-segment elevation in avR lead in paroxysmal supraventricular tachycardia( PSVT) . Methods Electrophysiological testing and radiofrequency catheter ablation( RFCA) in 150 patients of PSVT were per-formed routinely, with AVRT 82 cases and AVNRT 68 cases. avR lead terminal QRS morphology and ST-segment elevation ( horizontal, up-slope type, and down-slope type) in sinus rhythm and ventricular tachycardia episodes were observed. Results Of 68 AVNRT cases, termi-nal portion of the QRS complex morphological change in avR lead had 50 cases(73. 5%), and AVNRT diagnostic sensitivity, specificity, and positive predictive values were 72. 0%, 82. 4%, 83. 1%, respectively. Of 82 AVRT cases, ST segment elevation in avR lead had 59 ca-ses(72. 0%), and AVRT diagnostic sensitivity, specificity and positive predictive values were 73. 5%, 94. 0%, 91. 0%, respectively. Conclusion Compared with sinus rhythm, avR lead pseudo-r'or notching and ST-segment elevation play an important role in the identifica-tion of ventricular tachycardia.
出处
《安徽医学》
2015年第5期555-558,共4页
Anhui Medical Journal