结合临床特征和p波形态定位局灶性房性心动过速的起源

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Yun-peng Qu MD, Xiao-gang Guo MD, Jian Ma MD
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引用次数: 0

摘要

背景分析心电图(ECG)的p波形态可以确定局灶性房性心动过速(AT)的起源,从而为定位和消融提供信息。目的分析不同来源局灶性ATs的心电图和临床特征,改进2021年Kistler算法。方法对226例局灶性AT患者行射频导管消融治疗。通过心内电生理检查确定AT的来源。评估2021 Kistler算法的诊断价值。将常误诊病例的心电图和临床特征与来自邻近地区的AT患者进行比较。然后对算法进行修改和重新评估。结果Kistler算法对左心耳(LAA)、左肺静脉(LPV)、右心耳起源地的诊断敏感性分别为62.5%、61.1%、52.9%。连续发作是心房附件起源地的共同特征(P <;. 05)。起源于LPV的局灶性心房颤动比起源于LAA的局灶性心房颤动更容易伴有心房颤动(P <;. 05)。根据这些结果对算法进行了改进。新算法在左心房、左心室和右心房附件中区分起始点的灵敏度分别为75.0%、61.1%和70.6%;特异性分别为95.0%、96.6%和95.0%;准确率分别为94.2%、93.8%、96.9%。结论房颤的存在和发作的不间断有助于区分源自肺静脉和心房附件的局灶性心房颤动与源自邻近部位的局灶性心房颤动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Localizing the origin of focal atrial tachycardia by combining clinical characteristics with P-wave morphology

Background

Analyzing the P-wave morphology of an electrocardiogram (ECG) may determine the origin of focal atrial tachycardia (AT), thereby providing information for mapping and ablation.

Objective

We sought to analyze the ECG and clinical characteristics of focal ATs with different origins and to improve the 2021 Kistler algorithm.

Methods

We included 226 focal AT patients treated with radiofrequency catheter ablation. The origin of AT was determined by intracardiac electrophysiological examination. The diagnostic value of the 2021 Kistler algorithm was evaluated. The ECG and clinical characteristics of frequently misidentified cases were compared with those of patients with AT originating from adjacent locations. The algorithm was then modified and re-evaluated.

Results

The sensitivity of the Kistler algorithm for the diagnosis of left atrial appendage (LAA), left pulmonary vein (LPV), and right atrial appendage origins was 62.5%, 61.1%, and 52.9%, respectively. An incessant attack was a common feature of atrial appendage origins (P < .05). Focal AT originating from the LPV was more likely to be accompanied by atrial fibrillation than one originating from the LAA (P < .05). The algorithm was modified based on these results. The sensitivity of the new algorithm for distinguishing origins in the LAA, LPV, and right atrial appendage was 75.0%, 61.1%, and 70.6%; the specificity was 95.0%, 96.6%, and 95.0%; and the accuracy was 94.2%, 93.8%, and 96.9%, respectively.

Conclusion

The presence of atrial fibrillation and the incessancy of the attack can aid in distinguishing focal ATs originating from pulmonary veins and atrial appendages from those originating from adjacent locations.
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来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
审稿时长
52 days
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