DETERMINE 积分对右室流出道起源的室性早搏与 致心律失常性右室心肌病的鉴别诊断价值.

Objective To investigate the value of DETERMINE score in differentiating right ventricular outflow tract premature ventricular contraction (RVOT-PVC) and arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods Twenty-five patients with ARVC and 59 patients with RVOT-PVC were retrospectively analyzed. Their ECG parameters and characteristics of sinus rhythm were compared. DETERMINE score was calculated based on the number of leads with pathological Q waves, fragmented QRS complex, and T wave inversion. Results ARVC group in sinus rhythm has higher incidences of epsilon waves (12. 00% vs. 0, P < 0. 01), T wave inversion in leads V1 - V3 (68. 00% vs. 37. 29%, P = 0. 010) and ventricular tachycardia with left bundle branch block morphology (52. 00% vs. 16. 95%, P = 0. 001). The single ECG characteristic above is poor in identifying ARVC (sensitivity < 70. 0% ). The DETERMINE score in the ARVC group is significantly higher than that in the RVOTPVC group [(5. 80 ± 2. 56) vs. (0. 58 ± 1. 22), P < 0. 01]. The sensitivity and specificity of higher DETERMINE score( > 3) are separately 92. 0% and 91. 5% while positive and negative predictive values are 82. 8% and 98. 2%, respectively. Conclusion Simple DETERMINE score can be utilized to differentiate ARVC from RVOTPVC. The score system has certain clinical application value. [ABSTRACT FROM AUTHOR]