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.pdf

1142 CH INESE JOURNAL OF PRACT ICAL INTERNAL MEDICINE Aug 2006 Vol26 No15 1 1 1 2 3 1 钟幼民 , 郭继鸿 , 侯爱军 , 陈少军, 王 艳 , 张海澄 1005- 2194 (2006) 15- 1142- 03 R5 A 探讨典型房室结折返性心动过速和 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 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 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 4% 和 7% , 观察者间的符合率为 5% , 观察者内的符合率均为 9% 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 心电图; 房室结折返性心动过速; 房室折返性心动过速 M od ified e lec trocard iograph ic algor ithm for d ifferentiatin g typ ica l atrioven tricular node reen tran t tachy card ia * from atrioven tr icu lar rec iprocating tachy card ia m ed iated by con cea led accessory pathw ay. Zhong Youm in , Guo Jihong, H ou A ij un, et a.l * E lectrophysiology Laboratory, Departmen t of Car iology, P eking University Peop les H osp ital, B eij ing 100044, China A bstrac t O bject ive To evaluate the frequently used electrocard iographic criteria and propose am odified algorithm for d ifferentiating typ ical atrioventricular node reentran t tachycardia ( AVNRT) from atrioventricu lar reciprocating tachycar d ia (AVRT ). M e thod s Tw elve- lead electrocardiogram s ( ECGs) during s inus rhythm and atrioventricu lar node re entrant tachycardia (AVNRT) or atrioventricular reciprocating tachycard ia (AVRT) w ith a narrow QRS comp lex w ere obtained from 154 patients who had received successful radiofrequency catheter ablation from Jan2003 to Nov2005. The ECGs of in itial 104 patients w ere analyzed by 3 observers w ithout know ledge of the electrophysiolog ical diagnosis. A ccording to these in itial results, we proposed am odified stepw ise ECG algorithm wh ich used pseudo r/S/Q w aves, RP