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| 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) |
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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.
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