New algorithm using only lead AVR for differential diagnosis of wide QRS complex tachycardia

目的:应用Verecki新提出的单独运用aVR导联新法则对宽QRS 波心动过速进行鉴别诊断,评价其敏感性、特异性、阳性预测值、阴性预测值及诊断符合率.方法:选择200份经电生理检查诊断明确的宽QRS 波心动过速的心电图,采用单盲法由2位研究人员运用aVR导联新法则进行回顾性分析,并进行一致性检验后,统计aVR导联新法则每一步的诊断情况,计算敏感性、特异性、阳性预测值,阴性预测值及诊断符合率.结果:运用aVR导联新法则诊断的敏感性为97.6%,特异性为 67.7%,阳性预测值94.3%,阴性预测值为84.0%,诊断符合率为93.0%,对左室特发性室速的误诊例数为0.结论:单独运用aVR导联进行诊断具有高效准确,特别适合左室室速的鉴别诊断,适合临床应用.Objective:To diagnose wide QRS complex tachycardia using new algorithm of only lead AVR, and to evaluate the sensitivity, specificity, positive predictive value; negative predictive value and diagnose accordance rate.Method:In this study, the 200 patients with wide QRS complex tachycardia were retrospectively analyzed with new algorithm of only lead AVR by two of the authors blinded to the diagnosis. These patients have been diagnosed by proven electrophysiological. It was calculated for sensitivity, specificity, positive predictive value; negative predictive value and diagnose accordance rate. Result:The sensitivity of aVR new algorithm was 97.6%.The specificity was 67.7%.The positive predictive value was 94.3%.The negative predictive value was 84.0%.The diagnose accordance rate was 93.0%.Misdiagnosis of left idiopathic ventricular tachycardia was none.Conclusion:The method of new algorithm of only lead AVR is suitable to differential diagnoses left idiopathic ventricular tachycardia with high accuracy, which fits to clinical application.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)012952-9542