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目的探讨典型房室结折返性心动过速和经隐匿性旁道介导房室折返性心动过速的常用心电图鉴别诊断指标,提出并评价改良的鉴别诊断方案。方法收集2003年1月至2005年11月北京大学人民医院收治的154例患者窦性心律和心动过速发作时的心电图。在分析104例患者的心电图之后提出改良诊断方案,并利用50例患者的心电图进行评价。结果改良方案诊断房室结折返性心动过速及房室折返性心动过速的准确率分别为84%和87%,观察者间的符合率为85%,观察者内的符合率均为89%。结论改良诊断方案可以提高这两种心动过速的心电图鉴别诊断准确率。
Objective To explore the common diagnostic criteria of ECG in typical atrioventricular nodal reentrant tachycardia and occult atrioventricular reentrant tachycardia and to propose and evaluate an improved differential diagnosis scheme. Methods The ECGs of 154 patients with sinus rhythm and tachycardia were collected from Peking University People’s Hospital from January 2003 to November 2005. An improved diagnostic protocol was proposed after analyzing electrocardiograms of 104 patients and was evaluated using electrocardiography in 50 patients. Results The diagnostic accuracy of atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia was 84% and 87%, respectively. The coincidence rate between observers was 85%, and that of the observers was 89 %. Conclusion Improved diagnostic programs can improve the diagnostic accuracy of the two ECG tachycardia.