The role of frontal plane cardiac axis shift in the diagnosis of wide QRS tachycardia
10.3969/j.issn.1006-5725.2019.03.032
- VernacularTitle:心电轴偏转在宽QRS波心动过速体表心电图诊断中的作用
- Author:
Xiaoyong XU
1
;
Xianghong MENG
;
Haiwang GUAN
;
Fusheng MA
;
Jiangfang LIAN
;
Shijun GE
;
Jianqing ZHOU
Author Information
1. 宁波市医疗中心李惠利医院心血管内科
- Keywords:
Wide QRS complex tachycardia;
ventricular tachycardia;
cardiac axis;
electrocardiogram
- From:
The Journal of Practical Medicine
2019;35(3):476-478
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of axis shift between the baseline normal sinus rhythm (NSR) and WCT in diagnosis of wide QRS-complex tachycardia (WCT). Methods 390 surface ECGs of 186 patients with WCT were obtained from April 2012 to April 2018 at Ningbo Medical Center Lihuili Hospital at which the arrhythmia diagnosis was proven by intracardiac electrophysiological study. The axis shift between the baseline NSR and WCT was calculated by table lookup method. Then we analyzed the role of axis shift in diagnosis of WCT. Results Among the 186 patients with WCT, 147 (79.03％) were ventricular tachycardia (VT) , and 39 (20.97％) were supraventricual tachycardia (SVT) with conduction abnormalities. In the 95％ confidence interval, the axis shift showed an outstanding discrimination performance. The area under the ROC curve is 0.708 (0.579-0.817, P =0.007). Compared with left axis deviation, right axis deviation, the right axis deviation of LBBB morphology, the axis shift> 68 degree is more sensitive (53.06％) , and the specificity (91.43％) is also more desirable. Moreover, if the axis shift set> 130 degree, the specificity can reach 100％, and the sensitivity (12.24％) is equivalent to northwestern axis. Conclusion A significant axis shift between the baseline NRS and WCT can distinguish WCT accurately. Given the ease of grasping, it can probably be feasible to popularize as a routine diagnosis method for WCT in primary hospitals.
