多形性宽QRS波群心动过速：鉴别诊断

Polymorphic Wide QRS Complex Tachycardia: Differential Diagnosis.

作者信息

Jebberi Zeynab, Marazzato Jacopo, De Ponti Roberto, Bagliani Giuseppe, Leonelli Fabio M, Boveda Serge

机构信息

Cardiac Arrhythmia Management Department, Clinique Pasteur, BP 27617, 45 Avenue de Lombez, Toulouse 31076, France.

Department of Heart and Vessels, Ospedale di Circolo and Macchi Foundation, University of Insubria, Viale Borri, 57, Varese 21100, Italy.

出版信息

Card Electrophysiol Clin. 2019 Jun;11(2):333-344. doi: 10.1016/j.ccep.2019.02.004. Epub 2019 Apr 12.

DOI:10.1016/j.ccep.2019.02.004

PMID:31084854

Abstract

Polymorphic wide QRS complex tachycardia is defined as a tachyarrhythmia showing variable and frequently alternating morphologies of the QRS complex with irregular R-R intervals. It may present with a specific and reproducible pattern including torsade de pointes and bidirectional ventricular tachycardia or with a nonspecific and very irregular pattern, different from ventricular fibrillation. Polymorphic ventricular tachycardia is a challenging diagnosis and is associated with a high risk for sudden cardiac death. Although rare, preexcited atrial fibrillation over multiple accessory pathways can also generate a polymorphic wide QRS complex tachycardia mimicking polymorphic ventricular tachycardia.

摘要

多形性宽QRS波群心动过速被定义为一种快速心律失常，其QRS波群形态多变且常交替出现，R-R间期不规则。它可能呈现出特定且可重复的模式，包括尖端扭转型室速和双向性室性心动过速，或者呈现出非特异性且非常不规则的模式，与心室颤动不同。多形性室性心动过速是一种具有挑战性的诊断，且与心脏性猝死的高风险相关。虽然罕见，但通过多条旁路的预激性心房颤动也可产生类似多形性室性心动过速的多形性宽QRS波群心动过速。