aVR导联ST段抬高对阵发性室上性心动过速的鉴别价值

目的探讨aVR导联ST段抬高及其持续时间对阵发性室上性心动过速(PSVT)的鉴别价值。方法126例行射频消融治疗成功的PSVT患者,其中房室折返性心动过速(AVRT)65例,房室结折返性心动过速(AVNRT)61例。分析其aVR导联ST段抬高幅度及持续时间。结果65例AVRT中aVR导联ST抬高且持续时间≥0.08s有46例,61例AVNRT中有13例,诊断AVRT的敏感性、特异性及阳性预测值分别为70.8%,78.7%,78.0%;46例aVR导联ST段抬高的AVRT中左侧旁道占38例,诊断左侧旁道的敏感性、特异性及阳性预测值分别为79.2%,52.9%,82.6%。结论aVR导联ST段抬高及其持续时间有助于鉴别阵发性室上性心动过速,且其多发生于左侧旁道。

Value of ST segment elevation in aVR lead for differentiating paroxysmal snpraventricular tachycardin

Objective To explore the values of ST segment elevation in lead aVR for differentiating paroxysmal supraventricular tachycardia(PSVT).Methods A total of 126 12-lead electrocardiograms during PSVT was analyzed,each patient underwent a complete electrophysiologic study and radiofrequence ablation.65 cases were atrioventricular reciprocating tachycardia(AVRT) and 61 cases were atrialventricular nodal reentrant tachycardia(AVNRT).Results There were 46 cases of AVRT and 13 cases of AVNRT with aVR ST-segment elevation.The sensitivity,specificity,and positive predictive value of ST-segment elevation in aVR lead to differentiate AVRT from AVNRT were 70.8%,78.7%,78.0% respectively.Among 46 cases of AVRT with ST-segment elevation in aVR lead,there were 38 left side.The sensitivity,specificity,and positive predictive value of aVR ST-segment elevation to localize left side accessory pathways were 79.2%,52.9%,82.6% respectively.Conclusion ST-segment elevation in aVR lead and lasting time during PSVT are helpful parameters in differentiating AVRT with AVNRT,and favors the left side accessory pathway.