V2导联R波振幅指数联合R波时限指数对流出道室性心律失常心电图定位的研究-内科学专业论文.docxVIP

山西医科大学硕士学位论文 山西医科大学硕士学位论文 II I I V2 导联 R 波振幅指数联合 R 波时限指数 对流出道室性心律失常心电图定位的研究 摘要 目的： 探讨 V2 导联 R 波振幅指数联合 R 波时限指数对流出道室性心律失常（VA）心电 图定位的临床意义。 方法： 回顾性分析接受射频消融治疗成功的起源于流出道的 VA 患者心电图资料，计算 其 V2 导联 R 波振幅指数和 R 波时限指数，并与射频消融结果相比，采用 ROC 曲线 进行分析，计算在最佳的临床价值界点时的灵敏度、特异度及曲线下面积，并采用联 合定位进行分析。 结果： 以 V2 导联 R 波振幅指数 0.344 为定位右室流出道室性心律失常（RVOT）的界 值，灵敏度、特异度分别为 0.875、0.834，曲线下面积为 0.906；以 V2 导联 R 波时 限指数 0.510 为定位右室流出道室性心律失常(RVOT)的界值，其灵敏度、特异度分 别为 0.813、0.881，曲线下面积为 0.892；采用两指标的串联实验进行的诊断，可将 特异度提高到 0.980。 结论： V2 导联 R 波振幅指数和 R 波时限指数联合定位右室流出道室性心律失常在灵敏 度和特异度上具有很好的互补作用，对鉴别左、右流出道室性心律失常具有重要的临 床价值。 II II II 关键词：心电图定位；流出道；室性心律失常；ROC 曲线 II III PAGE III Study of outflow tract ventricular arrhythmia electrocardiographic localization by combing R wave amplitude index and R wave duration index in lead V2 Abstract Objective: To investigate the clinical significance of the combined R wave amplitude index and R wave duration index in lead V2 in outflow tract ventricular arrhythmia electrocardiographic localization. Methods: ECG of 74ventricular tachycardia patients origing from outflow tract were retrospectively studied. R wave amplitude index and R wave duration index in lead V2 were calculated and were compared with the results of catheter ablation. Adopted to ROC curve analysis in order to find cut off point and calculate the sensitivity, specific and area under the curve. Results: The sensitivity, specific degree of accuracy for R wave amplitude index were 0.875, 0.834 with R wave amplitude index≤0.344; the sensitivity, specific, degree of accuracy for R wave duration index were 0.813, 0.881 with R wave duration index≤0.510; the specific can be increased to 0.960 with the combined location method. Conclusions: The combined location method of R wave amplitude index and R wave duration index has good complementary effect on the sensitivity and specificity, and has important clinical IV IV PAGE IV value in outflow tract ventricular arrhythmia Key words: electrocardiographic localization; outflow tract; ventricula