Rhythm diagnosis in regular wide complex tachycardia

Brugada's Criteria

1. Absence of an RS complex in all precordial leads?
   1. If yes then VT
2. R to S interval >100ms in one precordial lead?
   1. If yes then VT
3. AV dissociation
   1. If yes then VT
4. Morphology criteria for VT present both in V1-2 and V6?
   1. If yes then VT
   2. If no then SVT

VTach vs. SVT

	V Tach	SVT w/ Aberrancy
Age	>50	<35
History	MI, CHF, CABG, MVR	MVR, WPW
Cannon A Waves	Present	Absent
Arterial Pulse	Variation	No variation
First heart sound	Variable	Not variable
Fusion Beats	Present	Absent
AV dissociation	Present	Absent
QRS	>0.14sec	<0.14sec
Axis	Extreme LAD (< -30)	Normal or slightly abnl
Vagal Maneuvers	No response	Slows or terminates
If RBBB present	V1 - R or qR V6 - rS	V1 - RSR' V6 - Rs
If LBBB present	V1/V2 - Broad R wave (>40msec) V6 - Any Q or QS	V1/V2 - Small R V6 - no Q

See Also

Tachycardia (Wide)

Source

7/2/09 Pani 4/2/10 Niemann