房颤伴室性早博与房颤伴差异性传导的量化鉴别方法研究

doi:10.3969/j.issn.0258-8021.2015.02.001

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摘要对于房颤伴室性早博与房颤伴差异性传导的临床诊断，目前还没有公认的标准，二者的准确鉴别一直是困扰医生的难题。本研究提出一种准确性高的计算方法，用于鉴别上述两类疾病。通过分析房颤伴室性早博与房颤伴差异性传导的临床特征，确定类代偿间期与联律间期的比值为鉴别特征参数。对待检测ECG信号作预处理，然后准确定位待检测ECG的每一个心动周期内QRST特征波；在此基础上，识别宽大畸形QRS 波群，提取对应于类代偿间期与联律间期的两个相邻RR间期，计算它们的比值，将其与一个给定的鉴别阈值进行比较后作出判别。算法验证数据来自MITBIH心律失常数据库，10个记录中，含4 026心拍房颤伴室性早搏和949心拍房颤伴差异性传导，共计4 975心拍。
所提出方法在房颤伴室性早博与房颤伴差异性传导的混合数据中，鉴别房颤伴室性早搏的灵敏度和阳性预测率分别达到了9315%和9830%，优于传统方法。类代偿间期与联律间期的比值可以代替目前常用的类代偿间期，作为鉴别房颤伴室性早博与房颤伴差异性传导的特征参数，对提高诊断正确性具有指导作用。

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	钱梦瑶饶妮妮^#*刘定宇杨阳张莹万永利

关键词 ：房颤伴室性早博, 房颤伴差异性传导, 鉴别, 类代偿间期, 联律间期

Abstract：For the clinical diagnosis of AF with premature ventricular contraction (AF with PVC) and AF with aberrant ventricular conduction (AF with AVC), there are no recognized standards, which make it very difficult for a cardiologist to accurately discriminate the two diseases. This paper intends to develop a highaccuracy calculation method to discriminate between these two types of diseases. Methods：By analyzing clinical features of AF with PVC and AF with AVC, we confirmed the ratio between coupling interval and compensatory pause as the identifiable characteristic parameter. The electrocardiogram (ECG) signal that to be detected was preprocessed, then we located QRST characteristic waves during each cardiac cycle of ECG signal. On this basis, we identified the wide freak QRS complexes, extract the two adjacent RR intervals corresponding to the coupling interval and compensatory pause in a wide freak QRS complex, and calculate their ratio. After comparing with a given discrimination threshold, the types of diseases were judged. Results： The 10 record data for the algorithm validation were downloaded from the MITBIH Arrhythmia Database, which include 4 026 and 949 beats of atrial fibrillation with premature ventricular contraction and with aberrant ventricular conduction, a total of 4 975 beats.
For the mixed data containing AF with PVC and AF with AVC, the sensitivity and the positive predictive value of proposed method to discriminate AF with PVC reached 9315% and 9830% respectively, which are better than that of traditional methods. Conclusions：The ratio between the coupling interval and compensatory pause can take the place of coupling interval, which is commonly used to discriminate between AF with PVC and AF with AVC at present. This work provides guidance in the diagnostic accuracy of AF with PVC and AF with AVC.

Key words： AF with premature ventricular contraction AF with aberrant ventricular conduction discrimination coupling interval compensatory pause

基金资助:国家自然科学基金(81171411)

引用本文:

钱梦瑶饶妮妮^#*刘定宇杨阳张莹万永利. 房颤伴室性早博与房颤伴差异性传导的量化鉴别方法研究[J]. 中国生物医学工程学报, 2015, 34(2): 129-135.
Qian Mengyao Rao Nini^#*Liu Dingyu Yang Yang Zhang Ying Wan Yongli. Study on the Quantification for Discrimination of Atrial Fibrillation with Premature Ventricular Contraction and Aberrant Ventricular Conduction. journal1, 2015, 34(2): 129-135.

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http://cjbme.csbme.org/CN/10.3969/j.issn.0258-8021.2015.02.001 或 http://cjbme.csbme.org/CN/Y2015/V34/I2/129

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