發(fā)布時間：2018-02-14 20:50

  本文關(guān)鍵詞： 兒童 室性心律失常 流出道 心電圖　出處：《中國實用兒科雜志》2017年04期 　論文類型：期刊論文

【摘要】：目的探討兒童不同起源部位流出道室性心律失常的心電圖定位方法。方法應(yīng)用4種心電圖算法(V1或V2導(dǎo)聯(lián)R波時限指數(shù)及振幅指數(shù)、V2移行指數(shù)、移行區(qū)指數(shù)、V2S/V3R指數(shù))對2009年1月至2015年7月清華大學(xué)第一附屬醫(yī)院接受射頻消融治療的94例流出道室性心律失常兒童不同室性心律失常起源部位進行預(yù)判,并與術(shù)中射頻消融結(jié)果對比。結(jié)果 4種心電圖算法對兒童右室流出道室性心律失常起源的陽性預(yù)測值為78.6%~88.2%,敏感度為85.5%~91.3%,特異度為36.0%~68.0%;對左室流出道室性心律失常起源的陽性預(yù)測值為47.4%~71.4%,敏感度為36.0%~68.0%,特異度為85.5%~91.3%。對左冠竇起源室性心律失常陽性預(yù)測值、敏感度和特異度均遠高于右冠竇起源的室性心律失常(陽性預(yù)測值:66.67%~90.90%vs.10.00%~15.38%;敏感度為83.33%~100.00%vs.20.00%~60.00%;特異度為57.58%~90.91%vs.50.00%~76.47%)。結(jié)論 4種心電圖算法中V2移行指數(shù)陽性預(yù)測值對兒童右室流出道起源室性心律失常有較好的預(yù)測價值。采用僅區(qū)分左、右室流出道起源的定位方法,4種心電圖算法對兒童左室流出道起源室性心律失常預(yù)測值較低。將左室流出道分為左冠竇和右冠竇起源,對左冠竇起源室性心律失常預(yù)測水平明顯提高。
[Abstract]:Objective to investigate the electrocardiographic localization of ventricular arrhythmias in children with outflow tract at different origination sites. Methods four electrocardiographic algorithms were used to determine the R wave duration index and amplitude index of V _ 1 or V _ 2 leads. From January 2009 to July 2015, 94 patients with outflow tract ventricular arrhythmias received radiofrequency ablation (RFCA) in the first affiliated Hospital of Tsinghua University. The origin sites of different ventricular arrhythmias in children with outflow tract ventricular arrhythmias were predicted. Results the positive predictive value of the right ventricular outflow tract arrhythmia in children with four electrocardiographic algorithms was 78.6 and 88.2, the sensitivity was 85.5 and 91.3, the specificity was 36.0 and 68.0, and the left ventricular outflow tract ventricular arrhythmia was caused by the left ventricular outflow tract arrhythmia. The positive predictive value of the source was 47.4 and 71.4, the sensitivity was 36.0 and 68.0, the specificity was 85.5 and 91.3. The positive predictive value of ventricular arrhythmia originated from the left coronary sinus. The sensitivity and specificity were significantly higher than those of ventricular arrhythmias originating from the right coronary sinus (positive predictive value: 66.67), 90.90vs.10.00 and 15.38; the sensitivity was 83.33; the sensitivity was 100.00vs.20.00; the specificity was 57.58 / 90.91vs.50.0076.477.Conclusion the positive predictive value of V2 transition index in the four electrocardiographic algorithms is useful for the development of the right ventricular outflow tract in children. Source ventricular arrhythmias have good predictive value. Methods for locating the origin of the right ventricular outflow tract (RVO), four electrocardiographic algorithms were used to predict the origin of ventricular arrhythmias in children. The left ventricular outflow tract was divided into left coronary sinus and right coronary sinus. The prediction level of ventricular arrhythmias originated from left coronary sinus was significantly improved.
【作者單位】： 清華大學(xué)第一附屬醫(yī)院心臟中心小兒科;
【基金】：首都醫(yī)學(xué)發(fā)展科研基金(2014-1-4121) 伍舜德博士醫(yī)學(xué)科學(xué)研究基金(202-400-00811)
【分類號】：R725.4

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