The Korean Journal of Medicine

  • 제99권4호
  • /
  • Pages.206-209
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  • 2024
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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좁은 QRS 빈맥의 진단

Diagnosis of Narrow QRS Tachycardia

  • 양필성 (차의과학대학교 분당차병원 심장내과)
  • Pil-Sung Yang (Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University)
  • 투고 : 2024.07.22
  • 심사 : 2024.07.30
  • 발행 : 2024.08.01
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초록

Narrow QRS tachycardia is a common clinical condition characterized by a heart rate exceeding 100 beats per minute and a QRS complex duration of less than 120 ms. This article provides an overview of the diagnostic approach to narrow QRS tachycardia, focusing on the differentiation between various supraventricular tachycardias, such as atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), atrial tachycardia (AT), and sinus tachycardia. The discussion includes an analysis of the presenting symptoms, electrocardiographic (ECG) findings, and the use of vagal maneuvers and pharmacological agents in diagnosis.

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참고문헌

  1. Michowitz Y, Tovia-Brodie O, Heusler I, et al. Differentiating the QRS morphology of posterior fascicular ventricular tachycardia from right bundle branch block and left anterior hemiblock aberrancy. Circ Arrhythm Electrophysiol 2017;10:e005074.
  2. Zimetbaum P, Josephson ME. Evaluation of patients with palpitations. N Engl J Med 1998;338:1369-1373. https://doi.org/10.1056/NEJM199805073381907
  3. Page RL, Wilkinson WE, Clair WK, McCarthy EA, Pritchett EL. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 1994;89:224-227. https://doi.org/10.1161/01.CIR.89.1.224
  4. Katritsis DG, Boriani G, Cosio FG, et al. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE). Eur Heart J 2018;39:1442-1445.
  5. Thavendiranathan P, Bagai A, Khoo C, Dorian P, Choudhry NK. Does this patient with palpitations have a cardiac arrhythmia? JAMA 2009;302:2135-2143. https://doi.org/10.1001/jama.2009.1673
  6. Gonzalez-Torrecilla E, Almendral J, Arenal A, et al. Combined evaluation of bedside clinical variables and the electrocardiogram for the differential diagnosis of paroxysmal atrioventricular reciprocating tachycardias in patients without preexcitation. J Am Coll Cardiol 2009;53:2353-2358. https://doi.org/10.1016/j.jacc.2009.02.059
  7. Gursoy S, Steurer G, Brugada J, Andries E, Brugada P. Brief report: the hemodynamic mechanism of pounding in the neck in atrioventricular nodal reentrant tachycardia. N Engl J Med 1992;327:772-774. https://doi.org/10.1056/NEJM199209103271105
  8. Appelboam A, Reuben A, Mann C, et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet 2015;386:1747-1753. https://doi.org/10.1016/S0140-6736(15)61485-4
  9. Letsas KP, Weber R, Siklody CH, et al. Electrocardiographic differentiation of common type atrioventricular nodal reentrant tachycardia from atrioventricular reciprocating tachycardia via a concealed accessory pathway. Acta Cardiol 2010;65:171-176. https://doi.org/10.2143/AC.65.2.2047050
  10. Katritsis DG, Josephson ME. Differential diagnosis of regular, narrow-QRS tachycardias. Heart Rhythm 2015;12:1667-1676. https://doi.org/10.1016/j.hrthm.2015.03.046