Table 5

ECG Criteria to Differentiate VT From SVT in Wide-Complex Tachycardia

Findings or Leads on ECG AssessedInterpretation
QRS complex in leads V1-V6 (Brugada criteria) (73)
  • Lack of any R-S complexes implies VT

  • R-S interval (onset of R wave to nadir of S wave) >100 ms in any precordial lead implies VT

QRS complex in aVR (Vereckei algorithm) (74)
  • Presence of initial R wave implies VT

  • Initial R or Q wave >40 ms implies VT

  • Presence of a notch on the descending limb at the onset of a predominantly negative QRS implies VT

AV dissociation
  • Presence of AV dissociation (with ventricular rate faster than atrial rate) or fusion complexes implies VT

QRS complexes in precordial leads all positive or all negative (concordant)
  • Implies VT

QRS in tachycardia that is identical to sinus rhythm (78)
  • Suggests SVT

R-wave peak time in lead II (78)
  • R-wave peak time ≥50 ms suggests VT

AV indicates atrioventricular; ECG, electrocardiogram; SVT, supraventricular tachycardia; and VT, ventricular tachycardia.

  • AV dissociation is also a component of the Brugada criteria (73).