P波形态对预测局灶性房性心动过速部位的研究

A study on the form of P wave in predicting the locus of focal atrial tachycardia

目的 探讨通过局灶性房性心动过速 (简称房速 )发作时的P波形态初步诊断左房或右房房速。方法 入选 33例房速病人 ,经成功的射频消融术治疗证实其中 10例起源于左房 ,2 3例起源于右房。回顾分析这些病例房速发作时的体表 12导联心电图 ,研究各导联P波形态与左房房速的相关性。结果 I导联和aVL导联P波负向预测左房房速的特异性分别达到了 10 0 %和 95 % ,但敏感性分别仅有 30 %和 5 0 % ;而V1导联P波正向的特异性和敏感性分别为 87%和 80 %。结论 通过房速发作时的P波形态分析 ,可初步预测房速的起源部位 。

Objective The aim of our study is to differentiate left atrial from right atrial tachycardia on the basis of P wave configuration during focal atrial tachycardia (AT).Methods Thirty-three patients with focal atrial tachycardia who had undergone successful radiofrequency catheter ablation were considered for inclusion in the study . Site of origin was the left atrium in 10 patients, and right atrium in 23 patients . The surface 12-lead ECG recordings during atrial tachycardia were reviewed in all patients. We analyzed the correlativity between P wave configuration and left atrial tachycardia.Results The specificity of negative P wave in lead I and aVL that indentifed a left atrial focus was 100% and 95% respectively, but the sensitivity was only 30% and 50% respectively. The specificity and sensitivity of positive P wave in V 1 that predicted a left atrial focus was 87% and 80%,respectively.Conclusion It is possible to predict the site of origin of focal atrial tachycardia by analyzing its P wave configuration,,and may be helpful for preparation before ablation.