Differential Diagnosis of Idiopathic Right Ventricular PVC or VT with Arrhythmogenic Right Ventricular Cardiomyopathy Concomitant PVC or VT by Hoffmayer ECG Integral
HOU Yanjiei, XU Hongwei, LUO Donglei, et al
Chengde Central Hospital / The Second Clinical College of Chengde Medical University, Hebei Chengde 067000, China
Abstract：Objective: To explore the clinical significance of the Hoffmayer ECG integral method in differential idiopathic right ventricular premature beat (PVC) or ventricular tachycardia (VT) with arrhythmogenic right ventricular cardiomyopathy (ARVC) PVC or VT in early stage. Method: 40 cases of heart disease patients admitted to Chengde Central Hospital from Nov. 2017 to Dec. 2020 were collected. Among the patients, 30 cases had right ventricular outflow tract PVC or VT, and 10 cases had ARVC sinus rhythm concomitant PVC or VT. The electrocardiogram of 40 patients in sinus rhythm with premature ventricular beats or ventricular tachycardia was analyzed by two ECG physicians according to the Hoffmayer ECG score method. The Hoffmeyer ECG scores of the 40 patients were analyzed using the total score method, then the Hoffmayer ECG scores of the 40 patients were analyzed using the individual score method, then compared to the clinical diagnosis, and finally, the negative predictive value, positive predictive value, specificity and sensitivity of the diagnosis were calculated for this analysis. Result: Statistically significant differences were found between the ARVC with premature or ventricular tachycardia group and the idiopathic premature or ventricular tachycardia group in terms of the proportion of total Hoffmayer points ≥5 and inversion of TV1-V3 (3 points) in the sinus rhythm chest leads with premature or ventricular tachycardia. The correct diagnosis of right ventricular idiopathic ventricular premature beats or ventricular tachycardia and ARVC patients with ventricular premature beats or ventricular tachycardia was 80.0% in sensitivity and 90.3% in specificity with a positive predictive value of 80.0% and a negative predictive value of 81.3% in 30 and 10 patients, respectively, using a Hoffmayer ECG score of ≥5. The negative predictive value, sensitivity, positive predictive value, and specificity of the single criterion of Tv1-v3 inversion in the thoracic leads of sinus rhythm for the diagnosis of ARVC patients with ventricular premature or ventricular tachycardia were 93.1%, 80.0%, 72.7%, and 90.0% respectively, with statistically significant differences between the two groups.Conclusion: The Hoffmayer ECG integration method ≥5 is effective in identifying patients with ARVC with right ventricular outflow tract ventricular premature beats or ventricular tachycardia or idiopathic right ventricular outflow tract ventricular premature beats or ventricular tachycardia. This method is specific, sensitive, rapid, simple, and has high clinical value.
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2022, Vol. 28 
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