González R, Pardo J
Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 1997 Feb;125(2):236-43.
The differential diagnosis of tachycardias with a widened QRS complex is a frequent problem that cardiologists and emergency room physicians must face. Ventricular tachycardias, supraventrical tachycardias with aberration of ventricular conduction and supraventricular tachycardias conducted by accessory routes (pre-exited or antidromic) are the three mechanisms that cause tachycardias with a widened QRS complex, whose clinical significance and treatments are different. Recently, intracardiac electrophysiological studies allowed the identification of efficient electrocardiographic criteria to distinguish each of these mechanisms. Several reports have indicated these criteria based on the careful analysis of the surface electrocardiogram.
QRS波群增宽的心动过速的鉴别诊断是心脏病专家和急诊医生必须面对的常见问题。室性心动过速、伴有心室传导异常的室上性心动过速以及通过附加途径（预激或逆向型）传导的室上性心动过速是导致QRS波群增宽的心动过速的三种机制，其临床意义和治疗方法各不相同。最近，心内电生理研究使得能够识别有效的心电图标准来区分这些机制中的每一种。几份报告基于对体表心电图的仔细分析指出了这些标准。
