资源描述：
《应用改良体表心电图三步法鉴别常见阵发性室上性心动过速临床评价》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、1142CHINESEJOURNALOFPRACTICALINTERNALMEDICINEAug2006Vol26No15论著应用改良体表心电图三步法鉴别常见阵发性室上性心动过速临床评价111231钟幼民,郭继鸿,侯爱军,陈少军,王艳,张海澄【文章编号】1005-2194(2006)15-1142-03【中图分类号】R5【文献标识码】A【摘要】目的探讨典型房室结折返性心动过速和经隐匿性旁道介导房室折返性心动过速的常用心电图鉴别诊断指标,提出并评价改良的鉴别诊断方案。方法收集2003年1月至2005年11月北京大学人民医院收治的154例患者窦性心律和心动过速发作
2、时的心电图。在分析104例患者的心电图之后提出改良诊断方案,并利用50例患者的心电图进行评价。结果改良方案诊断房室结折返性心动过速及房室折返性心动过速的准确率分别为84%和87%,观察者间的符合率为85%,观察者内的符合率均为89%。结论改良诊断方案可以提高这两种心动过速的心电图鉴别诊断准确率。【关键词】心电图;房室结折返性心动过速;房室折返性心动过速Modifiedelectrocardiographicalgorithmfordifferentiatingtypicalatrioventricularnodereentranttachycardia*fromatrioventric
3、ularreciprocatingtachycardiamediatedbyconcealedaccessorypathway.ZhongYoumin,*GuoJihong,HouAijun,etal.ElectrophysiologyLaboratory,DepartmentofCardiology,PekingUniversityPeoplesHospital,Beijing100044,ChinaAbstractObjectiveToevaluatethefrequentlyusedelectrocardiographiccriteriaandproposeamodified
4、algorithmfordifferentiatingtypicalatrioventricularnodereentranttachycardia(AVNRT)fromatrioventricularreciprocatingtachycardia(AVRT).MethodsTwelve-leadelectrocardiograms(ECGs)duringsinusrhythmandatrioventricularnodereentranttachycardia(AVNRT)oratrioventricularreciprocatingtachycardia(AVRT)withana
5、rrowQRScomplexwereobtainedfrom154patientswhohadreceivedsuccessfulradiofrequencycatheterablationfromJan2003toNov2005.TheECGsofinitial104patientswereanalyzedby3observerswithoutknowledgeoftheelectrophysiologicaldiagnosis.Accordingtotheseinitialresults,weproposedamodifiedstepwiseECGalgorithmwhichused
6、pseudor/S/Qwaves,RPinterva,landST-segmentelevationinleadaVRduringtachycardia.Twoobserversassessedthealgorithminadditional50patients.ResultsThealgorithmwasabletoincreasetheoverallaccuracyfrom77%and79%withoriginalalgorithmto84%and87%withthemodifiedalgorithm,respectively.Theinter-observerconcordanc
7、ewas85%.Theintra-observerconcordancewas89%inbothinvestigators.ConclusionThemodifiedalgorithmcanimprovetheaccuracyofdifferentialdiagnosisbetweentypicalAVNRTandAVRTviaconcealedaccessorypathway.KeywordsEle
