中国实用儿科杂志2017，Vol.32Issue(4)：300-303,4.DOI:10.19538/j.ek2017040616
儿童流出道室性心律失常起源部位心电图定位探讨
Utility of the electrocardiogram in localizing the orgin of outflow tract ventricular arrhythmias in children
摘要
Abstract
Objective To investigate the utility of the electrocardiogram (ECG) for differentiating origins of outflow tract ventricular arrhythmias (OTVAs) in children.Methods From January 2009 to July 2015,94 children with OTVAs were involved in this study,who were managed by radiofrequency catheter ablation (RFCA).The 4 types of ECG algorithm [(1)V l/V2 R wave duration index and amplitude index;(2)V2 trausition ratio;(3)Transition zoue index;(4)V2S/V3R index]were used to predicting the origins of OTVAs and the accuracy of prediction was compared with the results of RFCA.Results The positive predictive rate of 4 kinds of ECG algorithm localizing the right ventricular outflow tract (RVOT)ventricular arrhythmia in children was 78.6％ ～ 88.2％,the sensitivity was 85.5％ ～ 91.3％,and the specificity was 36.0％ ～68.0％.The positive predictive rate of 4 kinds of ECG algorithm localizing the left ventricular outflow tract (LVOT) ventricular arrhythmia was 47.4％ ～ 71.4％,the sensitivity was 36.0％ ～68.0％,and the specificity was 85.5％ ～ 91.3％.The positive predictive rate of 4 kinds of ECG algorithm localizing the LVOT ventricular arrhythmia in children was 47.4％ ～ 71.4％,the sensitivity was 36.0％ ～ 68.0％,and the specificity was 85.5％ ～ 91.3％.However,the subgroup analysis showed that for OTVAs originating from LCC,the positive predictive value,sensitivity and specificity were much higher than RCC origin of ventricular arrhythmia (predictive value:66.67％ ～ 90.90％ vs.10.00％ ～ 15.38％;sensitivity:83.33％ ～ 100.00％ vs.20.00％ ～ 60.00％;specificity:57.58％ ～ 90.91％ vs.50％ ～ 76.47％).Conclusion However,the 4 kinds of ECG algorithm used in adults are limited to predict the LVOT ventricular arrhythmias in children.If LVOT origin group is divided into the LCC and RCC origingroups,the results show that in LCC group the prediction level increases significantly.关键词
儿童/室性心律失常/流出道/心电图Key words
child/ventricular arrhythmia/outflow tract/electrocardiogram分类
医药卫生引用本文复制引用
江河,李小梅,李延辉,张宴,刘海菊..儿童流出道室性心律失常起源部位心电图定位探讨[J].中国实用儿科杂志,2017,32(4):300-303,4.基金项目
首都医学发展科研基金(2014-1-4121) （2014-1-4121）
伍舜德博士医学科学研究基金(202-400-00811) （202-400-00811）
