Motté G, Dinanian S, Mzabi H
Service de cardiologie, hôpital Antoine-Béclère, Clamart.
Arch Mal Coeur Vaiss. 1993 May;86(5 Suppl):715-24.
In monomorphic wide QRS complex tachycardia, it is important to differentiate ventricular tachycardia from supraventricular tachycardia with aberration or preexcitation both from the prognostic and therapeutic view points. Atrioventricular dissociation with fusion complexes allows diagnosis of ventricular tachycardia but the negative predictive value of these criteria is low. Extreme QRS axis deviation, concordant morphological criteria in leads V1-V2 and V6 and analysis of the RS complexes in the precordial leads, nearly always enable supraventricular tachycardia with aberration. The distinction with other causes of wide QRS complex tachycardias (supraventricular tachycardia with preexcitation or with non-systematized intraventricular conduction defects) is much more difficult in the absence of a reference recording and depends more on the clinical context than ECG analysis.
在单形性宽QRS波群心动过速中,从预后和治疗的角度来看,区分室性心动过速与伴有差异性传导或预激的室上性心动过速很重要。房室分离伴融合波可诊断室性心动过速,但这些标准的阴性预测价值较低。电轴极度偏移、V1-V2导联和V6导联形态标准一致以及胸前导联RS波群分析,几乎总能诊断伴有差异性传导的室上性心动过速。在没有参考记录的情况下,将其与宽QRS波群心动过速的其他原因(伴有预激或非系统性室内传导缺陷的室上性心动过速)区分开来要困难得多,并且更多地取决于临床情况而非心电图分析。