Puljević Mislav, Velagić Vedran, Pezo-Nikolić Borka, Puljević Davor
Lijec Vjesn. 2016 Sep-Oct;138(9-10):255-9.
Tachycardia is an arrhythmia characterized by heart rate > 100 / minute. According to the width of the QRS complex it can be divided into narrow QRS (< 120 ms) and wide QRS tachycardia (> 120 ms). Narrow QRS tachycardia is always supraventricular which means that its source is proximal to the bundle of His, while wide QRS tachycardia can be ventricular (source is in the ventricle, distal to the bundle of His) or supraventricular. The strategies for treating these two conditions are different so the correct diagnosis is prerequisite for optimal therapy. We present this case because the differential diagnosis of wide QRS tachycardia and therefore the treatment planning was particularly difficult due to concurrently present atrial fibrillation with hemodynamic compromise and an acute threat to the life of the patient.
心动过速是一种心律失常,其特征为心率>100次/分钟。根据QRS波群的宽度,可分为窄QRS波群(<120毫秒)和宽QRS波群心动过速(>120毫秒)。窄QRS波群心动过速总是室上性的,这意味着其起源位于希氏束近端,而宽QRS波群心动过速可以是室性的(起源于心室,在希氏束远端)或室上性的。治疗这两种情况的策略不同,因此正确诊断是优化治疗的前提条件。我们呈现此病例是因为宽QRS波群心动过速的鉴别诊断以及因此的治疗规划特别困难,原因是同时存在伴有血流动力学损害及对患者生命构成急性威胁的心房颤动。