Wide QRS complex tachycardia: differential diagnosis and acute treatment

Abstract

The methodical guidelines are devoted to the pressing problem of clinical cardiology – the diagnosis and treatment of wide QRS complex tachycardia, requiring an individualized approach to patients’ management. The basic principles of determination of wide QRS complex tachycardias and their electrophysiological mechanisms are reviewed. The etiology of wide QRS complex tachycardias, their clinical picture and ECG criteria for differential diagnosis, particularly between ventricular tachycardia and supraventricular tachycardia with aberrant ventricular conduction, are outlined. The basic principles of wide QRS complex tachycardias diagnosis are discussed, and the ECG signs of the certain «wide» are presented. The results of the studies, aimed at the development of the diagnostic criteria and algorithms for differential diagnosis of wide QRS complex tachycardias, are analyzed. The acute treatment of narrow and wide QRS complex tachycardias are presented. The antiarrhythmic drugs and their use are given, and the principles of catheter treatment of tachycardia are stated. The guidelines are addressed to cardiologists, internists, the functional diagnostics physicians, general practitioners (family physicians), interns.