Giá trị của các chuyển đạo điện tâm đồ cải tiến trong phân biệt vị trí khởi phát ngoại tâm thu thất từ đường ra thất phải và đường ra thất trái

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Tác giả: Văn Hoàng Đặng, Lân Hiếu Nguyễn, Việt Dũng Nguyễn, Trần Linh Phạm, Ngọc Cầm Trần, Hoàng Long Viên

Ngôn ngữ: vie

Ký hiệu phân loại: 612.1 Blood and circulation

Thông tin xuất bản: Tạp chí y học việt nam (tổng hội y học việt nam), 2022

Mô tả vật lý: 278-283

Bộ sưu tập: Metadata

ID: 489093

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Evaluation of the role of modified ECG leads in the differential diagnosis of premature ventricular complexes from the right ventricular outflow tract and the left ventricular outflow tract. Methods(:) Cross-sectional study 70 patients with premature ventricular complexes without structural heart disease, with indications for electrophysiology study and RF treatment. Results(:) Out of 70 patients with premature ventricular complexes originating from ventricular outflow tracts. The patients underwent electrophysiology study and successful RF ablation in the right ventricular outflow tract (RVOT(:) n=47) and left ventricular outflow tract (LVOT
n=23). Regarding the value of differential diagnosis of ventricular ectopy( )location, R wave amplitude index, S wave amplitude, R/S amplitude ratio, RWDI are valuable for differential diagnosis of ventricular outflow tract ectopy. RWDI is the index with the highest diagnostic value in the general study group and the group with electrocardiogram transition at V3. With the RWDI value ≤40 ms, the sensitivity is 95.7%, the specificity is 95.7% and the area under the AUC curve was 0.96 (95% CI 0.91-1.00) in the diagnosis of RVOT PVC in the study group. When comparing the RWDI index with some previous diagnostic criteria of the standard electrocardiogram in the general patient group and the group with transition at V3, the RWDI index proves to excel in terms of under-the-curve values as well as high sensitivity and specificity. Conclusion(:) New diagnostic criteria of modified electrocardiogram leads are valuable in the differential diagnosis of premature ventricular complexes originating from ventricular outflow tracts, among which the RWDI is the most valuable index in differential diagnosis and useful in clinical practice.Xác định giá trị của các chuyển đạo điện tâm đồ cải tiến trong chẩn đoán phân biệt vị trí khởi phát ngoại tâm thu thất từ đường ra thất phải và đường ra thất trái. Đối tượng và phương pháp nghiên cứu(:) Nghiên cứu cắt ngang 70 bệnh nhân ngoại tâm thu thất không có bệnh tim thực tổn và có chỉ định thăm dò điện sinh lý và điều trị RF. Kết quả nghiên cứu(:) Chúng tôi tiến hành nghiên cứu 70 bệnh nhân có ngoại tâm thu thất khởi phát từ đường ra tâm thất được thăm dò điện sinh lý và triệt đốt RF thành công ở đường ra thất phải (ĐRTP(:) n=47) và đường ra thất trái (ĐRTT
n=23). Về giá trị chẩn đoán phân biệt vị trí ngoại tâm thu thất, chỉ số biên độ sóng R, chỉ số biên độ sóng S, chỉ số tỷ số biên độ R/S, chỉ số RWDI có giá trị chẩn đoán phân biệt NTTT khởi phát từ đường ra tâm thất trong nhóm nghiên cứu. Trong đó chỉ số RWDI là chỉ số có giá trị chẩn đoán cao nhất ở nhóm nghiên cứu chung và nhóm NTTT chuyển tiếp tại V3. Với giá trị chỉ số RWDI ≤40 ms có độ nhạy 95,7%, độ đặc hiệu 95,7% và diện tích dưới đường cong AUC là 0,96 (95% KTạp chí 0,91-1,00) trong chẩn đoán NTTT từ ĐRTP trong nhóm nghiên cứu. Khi so sánh chỉ số RWDI với một số tiêu chuẩn( )trước đó của điện tâm đồ tiêu chuẩn ở nhóm bệnh nhân chung và nhóm chuyển tiếp tại V3, chỉ số RWDI cho kết quả cao nhất về giá trị dưới đường cong cùng với độ nhạy và độ đặc hiệu cao. Kết luận(:) Các tiêu chuẩn chẩn đoán mới của các chuyển đạo điện tâm đồ cải tiến có giá trị chẩn đoán phân biệt NTTT từ đường ra tâm thất.Trong đó chỉ số RWDI là chỉ số có giá trị nhất trong chẩn đoán phân biệt và hữu dụng trong thực hành lâm sàng bác sỹ nhịp học.

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