P波对局灶性房性心动过速起源部位的预测价值

目的：探讨通过局灶性房性心动过速（简称房速）发作时的P波形态初步诊断左、右房速的临床价值。方法：回顾性分析本院（68例）局灶性房性心动过速患者心电图，经成功的消融术治疗证实。结果：心电图与消融治疗诊断局灶性房速起源的比较，无明显差异（P〉0．05）。VⅠ导联房性P波负向或正负双向预测右房房速的特异性为100％，敏感性为97％；Ⅰ导联和aVL导联P波负向预测左房房速的特异性分别达到了98％和95％，但敏感性分别仅有33％和62％；而VⅠ导联P波正向的特异性和敏感性分别为100％和95％。结论：通过房速发作时的P波形态分析，可初步预测房速的起源部位，为临床合理治疗提供参考依据。

The Predictive Value of P Wave in Indentifying the Site of Origin of Focal Atrial Tachycardia

Objective To investigate clinical value of P wave in primary diagnosis of left and right focal atrial tachycardia. Methods To compare the predictive value of electrocardiogram（ECG）with that of radiofrequency ablation in focal atrial tachycardia in 68 cases. Results There is no difference （P 〉 0.05） between ECG and radiofrequency in predictive value on source locus. The specificity was 100%, sensitivity was 97% of V l lead atrial tachycardia P wave negative direction or positive negative in prediction of right atrial focus; the specificity were 98% and 95% of I lead and aVL lead P wave that identified left atrial focus, while sensitivity were 33% and 62%; The specificity and sensitivity were I00% and 95% of V1 lead P wave positive direction. Conclusion Analysis of P wave form on atrial tachycardia might predict site of origin and provide reference basis for clinical treatment.