宽QRS波心动过速的鉴别与处理

The Identification and Management of Wide QRS Tachycardia

宽QRS波心动过速起源部位的诊断对于心动过速的治疗事关重大。本文深入分析讨论了相关的若干问题:1.出现宽QRS波心动过速的几种可能;2.QRS波的形态对诊断宽QRS波心动过速起源部位的经典认识;3.Brugada对室性心动过速QRS波形态的总结和认识;4.Bougada宽QRS波心动过速的4步鉴别法;5.注意对维拉帕米敏感的宽QRS波心动过速的鉴别;6.房室分离和室性融合在诊断宽QRS波心动过速起源部位中的价值;7.右束支阻滞样宽QRS波心动过速"兔耳征"的判断价值;8.aVR导联的QRS波图形在宽QRS波心动过速鉴别诊断中的价值;9.Vi/Vt比值和新4步法在宽QRS波心动过速鉴别诊断中的价值;10.心脏电生理学检查在宽QRS波心动过速起源部位判别中的价值;11.临床表现及病史在鉴别宽QRS波心动过速起源部位中的意义;12.宽QRS波心动过速的一般处理原则。这些分析与讨论对于正确判断宽QRS波心动过速起源部位及相应的处理有重要的临床指导意义。

The diagnosis on the source location of wide QRS tachycardia is very important for tachycardia treatment. This paper discusses a number of issues as follows： 1. Several possibilities of wide QRS tachycardia appear; 2. The classical understanding on morphology of the QRS wave in the diagnosis of origin position of wide QRS wave tachycardia; 3. Brugada＇s summary and understanding on QRS waveform of ventricular tachycardia; 4. Four step methods for the identification of wide QRS tachycardia; 5.Note the identification of wide QRS tachycardia sensitivie to Vera Pammy; 6.The value of the diagnosis on the source location of wide QRS tachycardia on atrioventricular dissociation and fusion; 7.The value of wide QRS tachycardia with right bundle branch blocking; 8.The value of aVR QRS waveform in the identification of wide QRS tachycardia; 9.The value of Vi/Vt ratio and four step methods in the identification of wide QRS tachycardia; 10.The value of cardiac electrophysiology in the identification of origin position of wide QRS wave tachycardia; 11.The value of the clinical characteristic and medical history in the identification of origin position of wide QRS wave tachycardia; 12.The general principles of management on wide QRS tachycardia. The analysis and discussion have important clinical significance for the judgment of the origin position of wide QRS wave tachycardia and the relevant treatment.