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宽 QRS 波心动过速(wide QRS complex tachycardia,WCT)是指频率>100次/分和 QRS 波时限≥120 ms 的心动过速。室性心动过速(Ventricular tachycardia,VT)和部分室上性心动过速(supraventricular tachycardia,SVT)均可以表示为WCT,但二者的危险性和治疗大相径庭。特别是 VT 为一种严重的心律失常,可引起心室扑动甚至心室颤动,如不能及时终止,可导致心脏性猝死。因此及时和正确地对 WCT 进行鉴别诊断是十分重要的。一、分类:根据宽 QRS 波群心动过速的发生机制主要可分为:1.VT,占80%左右,起源于希氏束以下,包括:(1)与希浦系有关的室速,分为左室分支性室速、束支折返性室速;(2)局灶起源的室速,分为左室流出道室速、右室流出道室速、右室流入道室速、右室心尖部室速、左室游离壁室速等;(3)心肌缺血或坏死后室速,包括心肌梗死、心肌炎、心肌病、严重心衰并发的
Wide QRS complex tachycardia (WCT) refers to tachycardia with frequency> 100 beats / min and QRS wave duration> 120 ms. Both ventricular tachycardia (VT) and supraventricular tachycardia (SVT) can be expressed as WCT, but the risks and treatment of the two are very different. In particular, VT is a serious arrhythmia, can cause ventricular flutter and even ventricular fibrillation, if not promptly terminated, can lead to sudden cardiac death. Therefore, timely and correct differential diagnosis of WCT is very important. First, the classification: According to wide QRS complex tachycardia mechanism can be divided into: 1.VT, accounting for about 80%, originated in the following His bundle, including: (1) and the Hippo-related ventricular tachycardia, Divided into left ventricular branch ventricular tachycardia, bundle branch reentry ventricular tachycardia; (2) focal origin of ventricular tachycardia, divided into left ventricular outflow tract ventricular tachycardia, right ventricular outflow ventricular tachycardia, right ventricular tachycardia ventricular tachycardia right Ventricular apical ventricular tachycardia, left ventricular free wall velocity; (3) myocardial ischemia or necrosis ventricular tachycardia, including myocardial infarction, myocarditis, cardiomyopathy, severe heart failure complicated