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学科主题: 临床医学
题名:
A modified electrocardiographic algorithm for differentiating typical atrioventricular node re-entrant tachycardia from atrioventricular reciprocating tachycardia mediated by concealed accessory pathway
作者: Zhong, Y. M.; Guo, J. H.; Hou, A. J.; Chen, S. J.; Wang, Y.; Zhang, H. C.
关键词: electrocardiography ; atrioventricular node re-entrant tachycardia ; atrioventricular reciprocating tachycardia ; differential diagnosis
刊名: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
发表日期: 2006-11-01
DOI: 10.1111/j.1742-1241.2006.00839.x
卷: 60, 期:11, 页:1371-1377
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal ; Pharmacology & Pharmacy
研究领域[WOS]: General & Internal Medicine ; Pharmacology & Pharmacy
关键词[WOS]: ST-SEGMENT ELEVATION ; QRS COMPLEX TACHYCARDIA ; LEAD AVR ; SUPRAVENTRICULAR TACHYCARDIA ; 12-LEAD ELECTROCARDIOGRAM ; MYOCARDIAL-INFARCTION ; NARROW ; MECHANISM
英文摘要:

Non-invasive prediction of tachycardia mechanism is becoming clinically important in the era of catheter ablation for curing supraventricular tachycardia.

Twelve-lead electrocardiograms (ECGs) during sinus rhythm and atrioventricular node re-entrant tachycardia (AVNRT) or atrioventricular reciprocating tachycardia (AVRT) with a narrow QRS complex were obtained from 154 consecutive adult patients who had received successful radiofrequency catheter ablation. The ECGs of initial 104 patients were analysed by three observers without knowledge of the electrophysiological diagnosis. The two arrhythmias were accurately diagnosed in 68% of cases. Three criteria were found to be discriminators of tachycardia mechanism by univariable analysis. Pseudo r/Q/S waves predicated AVNRT in 92% of cases (sensitivity 71%; specificity 95%). Retrograde P wave predicated AVRT in 86% of cases (sensitivity 75%; specificity 85%), RP interval >= 100 ms in 93% (sensitivity 71%; specificity 94%) and ST-segment elevation in lead aVR in 83% (sensitivity 71%; specficity 83%). According to the initial results, we proposed a modified stepwise ECG algorithm which used pseudo r/S/Q waves, RP interval and ST-segment elevation in lead aVR during tachycardia. Two observers assessed the modified algorithm in the remaining 50 patients. The algorithm was able to correctly diagnose the tachycardia mechanism in 84% and 87%, respectively.

Using the modified algorithm can improve the accuracy and simplify the differential diagnosis between typical AVNRT and AVRT via concealed accessory pathway in adult patients.

语种: 英语
WOS记录号: WOS:000241190700009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/57469
Appears in Collections:北京大学第二临床医学院_心血管内科_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Dept Cardiol, Electrophysiol Lab, Beijing 100044, Peoples R China

Recommended Citation:
Zhong, Y. M.,Guo, J. H.,Hou, A. J.,et al. A modified electrocardiographic algorithm for differentiating typical atrioventricular node re-entrant tachycardia from atrioventricular reciprocating tachycardia mediated by concealed accessory pathway[J]. INTERNATIONAL JOURNAL OF CLINICAL PRACTICE,2006,60(11):1371-1377.
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