Hansel Diniz da Costa Carlos Arthur, Coelho Gabriela Menichelli Medeiros, Villar Rhanniel Theodorus Helhyas Oliveira Shilva Gomes, Coutinho Enia Lúcia, Cirenza Claudio, de Paola Angelo Amato Vincenzo
Federal University of São Paulo, São Paulo, Brazil.
Indian Pacing Electrophysiol J. 2024 Nov-Dec;24(6):309-314. doi: 10.1016/j.ipej.2024.10.005. Epub 2024 Oct 23.
Conventional three-lead ambulatory electrocardiogram recording (3L-AECG) is used for the quantitative diagnosis of arrhythmias. However, the lack of crucial information, such as QRS morphology and orientation, renders the 3L-AECG incomplete for planning electrophysiological interventions. The 12-lead AECG (12L-AECG) merges the temporal resolution 3L-AECG with the spatial resolution of the standard electrocardiogram (S-ECG). Although it provides more detail, it is not widely used. This study aimed to verify whether the seven-electrode 12L-AECG and S-ECG have similar waveforms.
A questionnaire consisting of 240 side-by-side comparisons (12 leads from 20 patients) was created. These consisted of a QRS registered using the 12L-AECG and a QRS from the same patient, registered using the S-ECG. The questionnaire was submitted to cardiologists trained in electrophysiology. For each comparison, the evaluator assigned "similar" or "different" depending on their own judgment.
Five cardiologists completed the questionnaire, resulting in 1200 answers. The AECG-12 was similar to the ECG in 84.50 % of the instances (95 % confidence interval [CI] 83.20-86.50). The interobserver agreement was moderate (0.542, p < 0.001). The similarity between specific leads ranged up to 98 % (95 % CI 92.96-99.76). No significant differences were found among patients (p = 0.407).
The seven-electrode 12L-AECG and S-ECG produced comparable waveforms. This similarity supports the use of 12L-AECG for accurate arrhythmia tracking and assists in planning electrophysiological procedures.
传统的三导联动态心电图记录（3L-AECG）用于心律失常的定量诊断。然而，由于缺乏诸如QRS波形态和方向等关键信息，3L-AECG在规划电生理干预方面并不完整。12导联动态心电图（12L-AECG）将时间分辨率的3L-AECG与标准心电图（S-ECG）的空间分辨率相结合。尽管它提供了更多细节，但并未得到广泛应用。本研究旨在验证七电极12L-AECG和S-ECG的波形是否相似。
创建了一份包含240组并排比较（来自20名患者的12导联）的问卷。这些比较包括使用12L-AECG记录的QRS波和同一患者使用S-ECG记录的QRS波。该问卷提交给接受过电生理培训的心脏病专家。对于每组比较，评估者根据自己的判断给出“相似”或“不同”的评价。
五位心脏病专家完成了问卷，共得到1200个答案。在84.50%的情况下，12导联动态心电图与心电图相似（95%置信区间[CI]83.20-86.50）。观察者间一致性为中等（0.542，p<0.001）。特定导联之间的相似性高达98%（95%CI 92.96-99.76）。患者之间未发现显著差异（p=0.407）。
七电极12L-AECG和S-ECG产生了可比的波形。这种相似性支持使用12L-AECG进行准确的心律失常跟踪，并有助于规划电生理程序。
