Differential diagnostic value of DETERMINE score for right ventricular outflow tract ventricular premature contraction and arrhythmogenic right ventricular cardiomyopathy
WANG Jun, XU Zongzheng, LI Qingzhu, WANG Xianghai, WANG Deguo
(1. Department of Geriatric Medicine, 2. Department of Medical Imaging, 3. Department of Cardiovascular Medicine, the First Affiliated Hospital of Wannan Medical College, Wuhu Anhui 241001, China)
Abstract：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 RVOT-PVC. The score system has certain clinical application value.
王俊，徐宗政，李庆祝，汪祥海，王德国. 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[J]. 实用心电学杂志, 2022, 31(5): 336-340.
WANG Jun, XU Zongzheng, LI Qingzhu, WANG Xianghai, WANG Deguo. Differential diagnostic value of DETERMINE score for right ventricular outflow tract ventricular premature contraction and arrhythmogenic right ventricular cardiomyopathy. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2022, 31(5): 336-340.
