avR导联在阵发性室上性心动过速中的鉴别诊断价值

The Diagnostic Value of avR Guide in the Paroxysmal Ventricular Tachycardia

目的探讨avR导联在阵发性室上性心动过速中的鉴别诊断价值。方法回顾性分析146例室上性心动过速患者资料,患者均行射频消融治疗,房室结折返性心动过速82例,房室折返性心动过速64例,比较两组对avR导联QRS波终末部形态异常、ST段抬高检出率的差异。结果与窦性心律相比,avR导联中,房室结折返组QRS波终末部形态异常检出率为72.0%高于房室折返组6.3%,比较具有统计学差异(P<0.05),房室结折返组ST段抬高检出率为19.5%高于房室折返组71.9%,比较具有统计学差异(P<0.05);结论 avR导联QRS波终末部形态异常、ST段抬高对阵发性室上性心动过速具有较高的诊断意义,与窦性心律相比较,值得临床选择。

Objective To explore the diagnostic value of avR guide in the paroxysmal ventricular tachycar- dia. Methods A retrospective analysis on the data of 146 cases of patients with supraventricular tachycardia was performed. Patients were all treated with radiofrequency ablation therapy. There were 82 cases of patients with atri-oventricular nodal reentrant tachycardia and 64 cases of patients with atrioventricular reentrant tachycardia. Finally, the differences between the two groups in the morphology abnormal at avR guide QRS wave terminal and the detec-tion ratio of the ST segment elevation were compared and analyzed. Results Compared with the sinus rhythm, in avR guide, the detection ratio of the morphology abnormal at QRS wave terminal in group of atrioventricular nodal reentrant was 72. 0% , which was 6.3% higher than that of group of atrioventricular reentrant （ P 〈 0. 05 ） . The de-tection ratio of ST segment elevation in group of atrioventricular nodal reentrant was 19. 5% , which was 71. 9 % higher than that of the group of atrioventricular reentrant （P 〈 0. 05 ） . Conclusion Compared with the sinus rhythm, the morphology abnormal at avR guide QRS wave terminal and the ST segment elevation show very high di-agnostic value in the paroxysmal ventricular tachycardia, which is worth to be applied in clinic.