Modified electrocardiographic algorithm for differentiating typical atrioventricular node reentrant tachycardia from atrioventricular reciprocating tachycardia mediated by concealed accessory pathway
- VernacularTitle:应用改良体表心电图三步法鉴别常见阵发性室上性心动过速临床评价
- Author:
Youmin ZHONG
;
Jihong GUO
;
Aijun HOU
- Publication Type:Journal Article
- Keywords:
Electrocardiography;
Atrioventricular node reentrant tachycardia;
Atrioventricular reciprocating tachycardia
- From:
Chinese Journal of Practical Internal Medicine
2006;0(15):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the frequently used electrocardiographic criteria and propose a modified algorithm for differentiating typical atrioventricular node reentrant tachycardia(AVNRT)from atrioventricular reciprocating tachycardia(AVRT).Methods Twelve-lead electrocardiograms(ECGs)during sinus rhythm and atrioventricular node reentrant tachycardia(AVNRT)or atrioventricular reciprocating tachycardia(AVRT)with a narrow QRS complex were obtained from 154 patients who had received successful radiofrequency catheter ablation from Jan.2003 to Nov.2005.The ECGs of initial 104 patients were analyzed by 3 observers without knowledge of the electrophysiological diagnosis.According to these initial results,we proposed a modified stepwise ECG algorithm which used pseudo r′/S/Q waves,RP interval,and ST-segment elevation in lead aVR during tachycardia.Two observers assessed the algorithm in additional 50 patients.Results The algorithm was able to increase the overall accuracy from 77% and 79% with original algorithm to 84% and 87% with the modified algorithm,respectively.The inter-observer concordance was 85%.The intra-observer concordance was 89% in both investigators.Conclusion The modified algorithm can improve the accuracy of differential diagnosis between typical AVNRT and AVRT via concealed accessory pathway.
