ABSTRACT
El diagnóstico electrocardiográfico correcto de la causa de una taquicardia de complejo QRS ancho (TCA) es fundamental, ya que tanto el manejo, como el pronóstico del paciente, es diferente según su etiología, y define el estudio que debemos realizar. Numerosos criterios y algoritmos han sido descritos para diferenciar el origen de estas taquicardias. Sin embargo, muchos de estos son complejos y difíciles de aplicar para el médico menos experimentado. Esto es particularmente importante en los servicios de emergencia, donde se necesita una definición rápida que permita un manejo agudo apropiado. En la presente revisión analizamos los diferentes mecanismos de las TCA y los principales criterios diagnósticos en el ECG, reforzando, especialmente, aquellos de aplicación rápida y de alto rendimiento diagnóstico.
The correct electrocardiographic diagnosis of the cause of a wide QRS complex tachycardia (WCT) is essential since both management and prognosis of the patient. The correct electrocardiographic diagnosis of the cause of a wide QRS complex tachycardia (WCT) is essential since both management and prognosis is different according to its etiology and defines the study that we should perform. Numerous criteria and algorithms have been described to differentiate the origin of these tachycardias. However, many of these are complex and difficult to apply to the less experienced doctor. This is particularly important in emergency rooms, where a rapid definition is needed to allow proper therapy. In this review we analyze the different mechanisms of WCT and the main EKG diagnostic criteria, emphasizing those which can be applied rapidly and have high diagnostic value.
Subject(s)
Humans , Tachycardia, Ventricular/diagnosis , Tachycardia/diagnosis , Tachycardia/physiopathology , Algorithms , Tachycardia, Supraventricular/diagnosis , Tachycardia, Supraventricular/physiopathology , Pre-Excitation Syndromes , Bundle-Branch Block , Tachycardia, Ventricular/physiopathology , Diagnosis, Differential , ElectrocardiographySubject(s)
Action Potentials , Bundle-Branch Block/diagnosis , Electrophysiologic Techniques, Cardiac , Heart Rate , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Ablation Techniques , Adult , Bundle-Branch Block/physiopathology , Cardiac Pacing, Artificial , Electrocardiography , Humans , Male , Predictive Value of Tests , Tachycardia, Atrioventricular Nodal Reentry/physiopathology , Tachycardia, Atrioventricular Nodal Reentry/surgery , Time FactorsSubject(s)
Accessory Atrioventricular Bundle/physiopathology , Action Potentials , Bundle-Branch Block/diagnosis , Electrophysiologic Techniques, Cardiac , Heart Rate , Tachycardia, Atrioventricular Nodal Reentry/diagnosis , Ablation Techniques , Accessory Atrioventricular Bundle/surgery , Bundle-Branch Block/physiopathology , Electrocardiography , Humans , Male , Predictive Value of Tests , Tachycardia, Atrioventricular Nodal Reentry/physiopathology , Tachycardia, Atrioventricular Nodal Reentry/surgery , Time Factors , Young AdultABSTRACT
Concealed conduction is a common electrocardiographic phenomenon whereby a series of events may occur as a result of incomplete propagation of an impulse. The occurrence, maintenance, and resolution (termination) of several events such as functional block and cardiac arrhythmias are linked to concealed conduction. This phenomenon should be suspected on the surface electrocardiogram whenever an arrhythmic event occurs unexpectedly. Several electrophysiological concepts such as transseptal conduction and linking phenomenon are close allies of concealed conduction. His-bundle electrocardiography and comprehensive electrophysiology may be needed to verify this phenomenon.
