| 徐嘉,王震,江昕,等.基于心电图的新算法在预激旁路定位中的准确性及可重复性研究[J].安徽医药,2026,30(8):1665-1669. |
| 基于心电图的新算法在预激旁路定位中的准确性及可重复性研究 |
| The accuracy and reproducibility of a new ECG-based algorithm for localizing accessory pathways in pre-excitation |
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| DOI：10.3969/j.issn.1009-6469.2026.08.036 |
| 中文关键词: 预激综合征 导管消融术 心电图 EPM算法 |
| 英文关键词: Pre-excitation syndromes Catheter ablation Electrocardiogram EPM algorithm |
| 基金项目:安徽省卫生健康科研项目( AHWJ2022b020) |
| 作者 | 单位 | E-mail | | 徐嘉 | 安徽医科大学第二附属医院,心电诊断科,安徽合肥 230601 | | | 王震 | 安徽医科大学第二附属医院,心血管内科,安徽合肥 230601 | | | 江昕 | 安徽医科大学第二附属医院,心电诊断科,安徽合肥 230601 | | | 王云 | 安徽医科大学第二附属医院,心电诊断科,安徽合肥 230601 | | | 马兰 | 安徽医科大学第二附属医院,心电诊断科,安徽合肥 230601 | | | 王晓晨 | 安徽医科大学第二附属医院,心血管内科,安徽合肥 230601 | hfdoc@126.com |
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| 中文摘要: |
| 目的探讨一种基于心电图的新算法( EPM算法)定位预激旁路的准确性和可重复性。方法回顾性分析 2019年 1月至 2024年 4月安徽医科大学第二附属医院因显性预激旁路行射频消融术的病人 107例，由 3名研究者在未知射频消融术结果的情况下运用 EPM算法和 Arruda算法对显性预激旁路进行定位，以射频消融术成功消融的靶点为金标准比较两种算法的准确率；采用受试者操作特征曲线( ROC曲线)评价两种算法对左侧旁路的诊断效能；运用研究者定位旁路时的一致性水平评估 EPM算法的可重复性。结果 EPM算法定位预激旁路的平均准确率明显高于 Arruda算法( 80.06%比 60.51%，P<0.05)且每位研究者运用 EPM算法定位的准确率均高于 Arruda算法；绘制 ROC曲线评价两种算法对左侧旁路的诊断效能显示， EPM算，法和 Arruda算法的曲线下面积分别为 0.96和 0.84，提示 EPM算法对左侧旁路的诊断价值明显高于 Arruda算法。在可重复性方面， EPM算法显示了良好的观察者间的变异性， Kappa统计量始终超过 0.9。结论 EPM算法作为一种新的定位预激旁路的心电图算法，对预激旁路定位的准确性高且其观察者间的一致性好，具有很好的临床适用性。 |
| 英文摘要: |
| Objective To evaluate the diagnostic accuracy and reproducibility of a novel electrocardiogram-based algorithm(EPM al-gorithm)in identifying the location of accessory atrioventricular pathways.Methods A retrospective analysis was conducted on 107 pa-tients who underwent radiofrequency catheter ablation(RFCA) for a manifest accessory pathway of Wolff-Parkinson-White syndromefrom January 2019 to April 2024 in The Second Affiliated Hospital of Anhui Medical University. Three researchers, blinded to the RF-CA results, used the EPM algorithm and the Arruda algorithm to localize the manifest accessory pathway (AP). The exact ablation siteof RFCA was used as the gold standard to compare the accuracy of the two algorithms. Receiver operating characteristic curve (ROCcurve) was used to assess the value of the two algorithms in predicting the left-sided AP. The reproducibility of the EPM algorithm was evaluated by the level of agreement among researchers in localizing the AP.Results Regarding the average accuracy, EPM algorithm was superior to the Arruda algorithm (80.06% vs. 60.51%, P<0.05). The EPM algorithm consistently demonstrated higher accuracy, re-gardless of the researcher. The areas under the ROC curve for localizing the left-sided AP were 0.96 and 0.84 for the EPM algorithmand the Arruda algorithm respectively, which indicated that the EPM algorithm was a significantly better predictor than the Arruda algo-rithm. Regarding the reproducibility, the EPM algorithm demonstrated excellent inter-observer variability, with Kappa statistics consis-tently exceeding 0.9.Conclusion The EPM algorithm, as a novel electrocardiogram-based algorithm for identifying the location of ac-cessory pathways, demonstrates high accuracy and excellent inter-observer consistency, thus making it highly applicable in clinical practice. |
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