移行区积分指数和V2S/V3R指数对定位流出道室性早搏起源的价值

The value of transition zone integral index and V2S/V3R index on the origin of ventricular premature beats

探讨移行区指数和V2S/V3R指数对流出道室性早搏(PVC)的定位诊断价值。回顾导管消融成功的流出道PVC 100例,分析左室流出道(LVOT)和右室流出道(RVOT)移行区积分指数及V2S/V3R指数特点及其敏感性与特异性。LVOT-PVC在V2导联前移行占63.6%(21/33),V2~V3占33.3%(11/33);ROVT-PVC在V3导联后移行占70.1%(47/67),V2~V3占14.9%(10/67);LOVT-PVC和ROVT-PVC移行区积分存在显著差异(P<0.01)。移行区积分指数<0 LVOT-PVC占81.8%(27/33),RVOT-PVC占26.9%(18/67),LOVT-PVC显著低于ROVT-PVC(P<0.01)。V2S/V3R指数<1.5 LVOT-PVC占75.6%(25/33),ROVT-PVC占89.6%(60/67),前者显著低于后者(P<0.01)。V2S/V3R指数截断值=2.17,敏感性83.6%,特异性为87.9%;移行区积分指数截断值=0.25,敏感性为91.0%,特异性为81.8%。移行区积分指数、V2S/V3R指数对流出道PVC定位诊断价值大,特别是V2~V3之间移行的流出道PVC。

To investigate the diagnostic value of the V2S/V3R index and the index on the positioning of premature ventricular circulation(PVC).100 cases of outflow tract PVC with successful catheter ablation were reviewed. The left ventricular outflow tract(LVOT) and right ventricular outflow tract(RVOT) transition zone integral index and V2S/V3R index characteristics and their sensitivity and specificity were analyzed.LVOT-PVC accounted for 63.6%(21/33) before V2 lead, and V3~V3 accounted for 33.3%(11/33);ROVT-PVC accounted for 70.1%(47/67) after V3 lead, and 14.9%(10/67) for V2~V3;there was a significant difference between LOVT-PVC and ROVT-PVC transition zone(P<0.01).The transition zone integral index<0 LVOT-PVC accounted for 81.8%(27/33), RVOT-PVC accounted for 26.9%(18/67), and LOVT-PVC was significantly lower than ROVT-PVC(P<0.01).V2S/V3R index<1.5 LVOT-PVC accounted for 75.6%(25/33), and ROVT-PVC accounted for 89.6%(60/67). The former was significantly lower than the latter(P<0.01).The V2S/V3R index cutoff value was 2.17, the sensitivity was 83.6%, the specificity was 87.9%;the transition zone integral index cutoff value was 0.25, the sensitivity was 91.0%, and the specificity was 81.8%.The transition index and V2S/V3R index have great value in the diagnosis of outflow channel PVC, especially the outflow channel PVC between V2 and V3.