小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 房室折返性心动过速 (AVRT)
其他诊断因素
- 心悸
- 头晕
- 呼吸短促
- 胸痛
- 心房颤动
- 心房扑动
- 先天性心脏畸形
- 心脏性猝死
- 晕厥和昏厥前兆
- 妊娠期心动过速
危险因素
- Ebstein 畸形
- 肥厚型心肌病
- 二尖瓣脱垂
- 房间隔缺损
- 室间隔缺损
- 大血管错位
- 主动脉缩窄
- 右位心
- 冠状静脉窦憩室
- 右和左心房动脉瘤
- 心脏横纹肌瘤
- 马凡综合征
- Friedreich 共济失调
- 家族史
诊断性检查
首要检查
- 12 导联心电图
需考虑的检查
- 超声心动图
- 平板运动试验
- 电生理学研究
治疗流程
不稳定：BP＜90/60 mmHg，全身灌注不足或不稳定性心房颤动的迹象
稳定：窄 QRS 波群（顺向型房室折返性）心动过速
稳定：宽 QRS 波群（逆向型房室折返性）心动过速
稳定：由心房颤动或心房扑动导致的预激性心动过速
稳定：由房性心动过速导致的预激性心动过速
急性治疗后：无症状
急性治疗后：有症状
撰稿人
作者
Hugh Calkins, MD
Professor of Medicine
Director of Electrophysiology
Johns Hopkins University School of Medicine
Baltimore
MD
利益声明
HC declares that he is a consultant for Medtronic and Biosense Webster; receives research support from Boston Scientific; is a contributor to Up to Date on atrial fibrillation, arrhythmogenic right ventricular dysplasia, and sarcoidosis; has reviewed and testified in medical malpractice cases; and has authored a chapter in the European Society of Cardiology textbook on Wolff-Parkinson-White syndrome.
鸣谢
Professor Hugh Calkins would like to gratefully acknowledge Dr David Frankel, Dr Mithilesh K. Das, and Dr Douglas P. Zipes, previous contributors to this topic. DF, MKD, and DPZ declare that they have no competing interests.
同行评议者
Joseph E. Marine, MD
Associate Professor of Medicine
Director of Electrophysiology
Johns Hopkins University School of Medicine
Baltimore
MD
利益声明
JEM declares that he has no competing interests.
Suneet Mittal, MD
Director
Electrophysiology Laboratory
The St. Luke's-Roosevelt Hospital Center
New York
NY
利益声明
SM declares that he has no competing interests.
Andrew Turley, MB ChB
Cardiology Specialist Registrar
The James Cook University Hospital
Middlesbrough
UK
利益声明
AT declares that he has no competing interests.
Steve Hsu, MD
Associate Professor
Department of Medicine
Division of Cardiology
University of Florida College of Medicine
Jacksonville
FL
利益声明
SH declares that he has no competing interests.
鉴别诊断
- 房束旁路
- Lown-Ganong-Levine 综合征
- 结-分支旁路
更多 鉴别诊断指南
- 2017 AHA/ACC/HRS 室性心律失常患者管理与心源性猝死预防指南
- 心房颤动管理指南
更多 指南患者教育信息
Atrial fibrillation: what is it?
Atrial fibrillation: what treatments work?
更多 患者教育信息
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