Differential diagnosis of tachycardias with wide QRS complexes

. Carrying out a differential diagnosis when tachycardias with wide QRS complexes occur, determining the genesis of these arrhythmias and choosing the right treatment tactics pose a serious problem in the practice of a doctor. Considering that such rhythm disturbances are often accompanied by hemodynamic destabilization and can be fatal, a medical decision should be made quickly, based on reliable and simple diagnostic criteria. The expansion of QRS complexes may indicate the ventricular genesis of tachycardia, or may be associated with the occurrence of tachy-dependent or the presence of an initial blockage of the bundle of Gis, violation of intraventricular conduction, antegrade conduction of excitation in supraventricular arrhythmia with the participation of an additional conductive pathway (DPP). The causes of paroxysmal tachycardia with wide QRS complexes are more often organic changes in the myocardium, but other causes are possible, such as exposure to toxic substances and drugs, electrolyte disturbances, the influence of an implanted pacemaker, cardioverter, etc.