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目的:探讨通过局灶性房性心动过速(简称房速)发作时的P波形态初步诊断左、右房速的临床价值。方法:回顾性分析本院(68例)局灶性房性心动过速患者心电图,经成功的消融术治疗证实。结果:心电图与消融治疗诊断局灶性房速起源的比较,无明显差异(P>0.05)。V1导联房性P波负向或正负双向预测右房房速的特异性为100%,敏感性为97%;I导联和aVL导联P波负向预测左房房速的特异性分别达到了98%和95%,但敏感性分别仅有33%和62%;而V1导联P波正向的特异性和敏感性分别为100%和95%。结论:通过房速发作时的P波形态分析,可初步预测房速的起源部位,为临床合理治疗提供参考依据。
Objective: To investigate the clinical value of preliminary diagnosis of left and right atrial tachycardia by P waveform of focal atrial tachycardia (atrial tachycardia). Methods: The electrocardiogram of patients with focal atrial tachycardia in our hospital (68 cases) were retrospectively analyzed and confirmed by successful ablation. Results: There was no significant difference between ECG and ablation in diagnosing the origin of focal atrial tachycardia (P> 0.05). V1 lead atrial P wave negative or positive bidirectional bi-directional prediction of right atrial velocity specificity was 100%, the sensitivity was 97%; I lead and aVL lead P wave negatively predict the specificity of left atrial velocity Respectively, reached 98% and 95%, but the sensitivity was only 33% and 62% respectively. The positive and negative P-wave specificity and sensitivity of V1 lead were 100% and 95% respectively. Conclusion: Through the analysis of P wave morphology at the onset of the tachycardia, the origin of the tachycardia can be preliminarily predicted, providing a reference for clinical rational treatment.