摘要
目的 :评价 12导联心电图在鉴别左室和右室流出道室性心动过速 (VT)及鉴别左室流出道VT中主动脉瓣上起源的VT和主动脉瓣下起源的VT中的价值。方法 :回顾性分析了射频消融术获得成功的 5 6例流出道特发性VT患者体表心电图特点 ,右室流出道VT组 (RVOT VT)组 4 0例 ,左室流出道VT(LVOT VT)组 16例 ,其中主动脉瓣上组 (左冠窦内 ) 10例 ,主动脉瓣下组 6例。结果 :LVOT VT组胸前导联R波移行均早于V4导联 ,87.5 %(14 / 16 )在V1或V2 导联 ,RVOT VT组 82 .5 % (33/ 4 0 )胸前导联R波移行≥V4导联 ,无一例在V3 导联前移行 ;RVOT VT组V1和V2 导联R波时限指数和R/S波幅指数明显小于LVOT VT组 [(30 .4± 12 .6 ) %∶(5 7.4± 14 .2 ) %和 (13.8± 7.5 ) %∶(5 8.2± 11.4 ) % ,均P <0 .0 1]。主动脉瓣上LVOT VT组下壁导联 (Ⅱ ,Ⅲ ,aVF)R波振幅明显高于主动脉瓣下组 ;V5和V6导联或单独V6导联有s波对确定主动脉瓣下起源的LVOT VT敏感性 10 0 % (6 / 6 ) ,V5和V6导联均无s波对确定主动脉瓣上起源的LVOT VT特异性 90 % (9/ 10 )。结论 :体表心电图对初步确定心室流出道VT的起源部位可以提供很大的帮助。
Objective:The study was designed to evaluate the value of 12 lead electrocardiogram (ECG) on differentiating left ventricular outflow tract ventricular tachycardia (LVOT-VT) from right ventricular outflow tract ventricular tachycardia (RVOT-VT), and on differentiating LVOT-VT originating from supravalvular region of a coronary cusp (Supra-Ao group) from the infravalvular endocardial region of the aortic valve (Infra-Ao group).Method:We performed a retrospective analysis of ECG of 56 patients with outflow tract idiopathic ventricular tachycardia who had undergone radiofrequency ablation successfully, including 40 patients with RVOT-VT 10 patients with Supra-Ao LVOT-VT and 6 patients with Infra-Ao LVOT-VT.Result:In LVOT-VT group, precordial R wave transition occurred all before lead V 4 , 87.5% (14/16) occurred on lead V1 or V 2, while in the RVOT-VT group, no patients' precordial R wave transition occurred before lead V 3, 82.5%(33/40)occurred ≥V 4; The index of R-wave duration and R/S amplitude on lead V 1 and V 2 in RVOT-VT group were significantly lower than in LVOT-VT group[( 30.4± 12.6)% vs ( 57.4± 14.2)% and ( 13.8± 7.5)% vs ( 58.2± 11.4)%,P< 0.01]. The R wave voltage in lead Ⅱ, Ⅲ and aVF in the Supra-Ao group was significantly greater than in the Infra-Ao group; The presence of an s wave in both V 5 and V 6 or only in V 6 identified an infra-Ao origin of LVOT-VT with a 100% sensitivity(6/6), absence of an s wave in either V 5 and V 6 identified a supra-Ao origin with an 90% specificity(9/10).Conclusion:Surface electrocardiogram can offer great help on identifying the origin of outflow tract idiopathic ventricular tachycardia.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2004年第8期455-457,共3页
Journal of Clinical Cardiology
关键词
心电描记术
心动过速
室性
Electrocardiography
Ventricular tachycardia
