The value of electrocardiographic criteria in differential diagnosis of right ventricular outflow tract ventricular arrhythmias
1.The Second Clinical Medical College of Wenzhou Medical University, Wenzhou, 325035; 2.Department of Cardiology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027
WANG Qiaoqiao1,LIN Jiaxuan2,LI Jin2, et al. The value of electrocardiographic criteria in differential diagnosis of right ventricular outflow tract ventricular arrhythmias[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(8): 574-.
Abstract：Objective: To evaluate the value of electrocardiographic (ECG) criteria in differential diagnosis of right ventricular outflow tract ventricular arrhythmias (RVOT VAs). Methods: The surface ECG pattern in 272 cases of right ventricular outflow tract VAs patients who underwent successful catheter ablation and compared with 72 cases of left ventricular outflow tract (LVOT) VAs patients were analyzed. Five criteria of the indexes of the R-wave amplitude<0.3 and duration<0.5, the precordial transitional zone index≥0, the V2 transition ratio<0.6 and precordial transition were observed≥V3 for diagnosing RVOT VAs and calculated their sensitivities, specificities, positive predictive values and negative predictive values. And recejver operating characteristic (ROC) curve analysis was conducted. Results: ①The corresponding sensitivities were 93.38%, 91.18%, 93.75%, 71.69% and 77.94%, respectively, the corresponding specificities were 87.50%, 88.89%, 91.67%, 88.89% and 93.06%, respectively, the corresponding positive predictive values were 96.58%, 96.88%, 97.70%, 96.06% and 97.70%, respectively, the corresponding negative predictive values were 77.78%, 72.72%, 79.52%, 45.39% and 52.76%, respectively. ②The areas under ROC curve according to different criteria were 0.904 (SE1: 0.024, 95% CI:
0.857~0.952), 0.900 (SE2: 0.024, 95% CI: 0.854~0.947), 0.927 (SE3: 0.021, 95% CI: 0.887~0.968), 0.803 (SE4: 0.027, 95% CI: 0.749~0.857), 0.855 (SE5: 0.023, 95% CI: 0.809~0.901). There were significant differences found in the comparisons between the indexes of the r-wave amplitude<0.3 and duration<0.5 and the V2 transition ratio<0.6, the precordial transitional zone index≥0 and the V2 transition ratio<0.6, the precordial transitional zone index≥0 and precordial transition≥V3 (Z statistics were 2.795, 2.685, 3.625, 2.311 respectively, all P<0.05). There were no significant differences found in the comparisons between the other criteria. Conclusion: The indexes of the r-wave amplitude<0.3 and duration<0.5 and the precordial transitional zone index≥0 are more effective than the other criterias in differential diagnosis of RVOT VAs.
