Romero M, Aranda A, Gómez F J, Jurado A
Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
Servicio de Cardiología, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
Semergen. 2014 Apr;40(3):e57-9. doi: 10.1016/j.semerg.2013.02.001. Epub 2013 Jun 13.
The differential diagnosis and therapeutic management of wide QRS tachycardia preceded by pacemaker spike is presented. The pacemaker-mediated tachycardia, tachycardia fibrillo-flutter in patients with pacemakers, and runaway pacemakers, have a similar surface electrocardiogram, but respond to different therapeutic measures. The tachycardia response to the application of a magnet over the pacemaker could help in the differential diagnosis, and in some cases will be therapeutic, as in the case of a tachycardia-mediated pacemaker. Although these conditions are diagnosed and treated in hospitals with catheterization laboratories using the application programmer over the pacemaker, patients presenting in primary care clinic and emergency forced us to make a diagnosis and treat the haemodynamically unstable patient prior to referral.
本文介绍了起搏器信号前宽QRS波心动过速的鉴别诊断和治疗管理。起搏器介导的心动过速、起搏器患者的心动过速性心房颤动/心房扑动和失控起搏器，具有相似的体表心电图，但对不同的治疗措施有不同反应。在起搏器上方应用磁铁对心动过速的反应有助于鉴别诊断，在某些情况下还具有治疗作用，如心动过速介导的起搏器情况。尽管这些情况在有导管室的医院通过起搏器应用程控仪进行诊断和治疗，但在基层医疗诊所和急诊科就诊的患者迫使我们在转诊前对血流动力学不稳定的患者进行诊断和治疗。
