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目的分析心电图aVR导联ST段抬高对阵发性室上性心动过速(PSVT)的鉴别诊断价值。方法选择2007年6月～2009年5月行射频消融治疗成功的PSVT患者218例,其中房室结折返性心动过速(AVNRT)123例,房室折返性心动过速(AVRT)95例,分析其室上速发作时心电图aVR导联ST段抬高的振幅,结合心内电生理检查结果进行对比分析。结果分析218例患者室上速发作时的心电图,123例AVNRT患者中,28例出现aVR导联ST段抬高,占22.8%;AVRT患者95例,其中74例aVR导联ST段抬高,占77.9%;左侧旁道86(86/95)例,其中73例室上速发作时,aVR导联ST段抬高,占84.9%。结论心电图aVR导联ST段抬高对判断旁道参与的阵发性室上速,特别是左侧旁道参与的阵发性室上速有重要的意义。
Objective To analyze the differential diagnosis of paroxysmal supraventricular tachycardia (PSVT) caused by ST segment elevation in aVR lead of ECG. Methods A total of 218 patients with PSVT who underwent radiofrequency catheter ablation from June 2007 to May 2009 were selected. Among them, 123 were atrioventricular nodal reentrant tachycardia (AVNRT), 95 were atrioventricular reentrant tachycardia (AVRT) The amplitude of ST segment elevation in the aVR lead of the supraventricular tachycardia was analyzed and compared with the result of electrophysiological examination. Results The electrocardiogram of 218 patients with supraventricular tachycardia was analyzed. Of the 123 patients with AVNRT, 28 cases showed aVR lead ST segment elevation, accounting for 22.8%; 95 cases of AVRT patients, including 74 aVR lead ST segment elevation, Accounting for 77.9%. There were 86 (86/95) cases in the left bypass. ST-segment elevation in aVR leads was found in 73 cases of supraventricular tachycardia (84.9%). Conclusions The ST segment elevation in lead aVR of ECG is of great significance in judging the paroxysmal supraventricular tachycardia, especially the paroxysmal supraventricular tachycardia in which the left accessory pathway participates.