Ventricular Tachycardia: Sensitivity and Specificity

Introduction: Most common cause of a wide-complex tachycardia (see also Supraventricular Tachycardia). See historical features and Brugada criteria here to distinguish from SVT with aberrancy.

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Differential Diagnoses include: Supraventricular Tachycardia

Prevalence

The sensitivity and specificity of findings for Ventricular Tachycardia are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Brugada Criteria	98.7%	96.5%	Note: Replication study found sensitivity = 80-90% and specificity = 40-70%, depending on observer. This study did include patients on antiarrhythmics, while Brugada's did not. Brugada Criteria - Flowchart as follows: Absence of RS in all precordial leads? Yes ->VT No-> RS int (start R - nadir S) > 100ms in one precordial lead? Yes ->VT No-> AV dissociation? Yes ->VT No-> Morphology criteria (if RBBB: V1 has monophasic R OR QR OR RS; V6 R<S OR QS OR QR OR monophasic R; or if LBBB: V1 or V2 has R>30ms OR RS > 60ms OR notched S; V6 QR or QS)? Yes ->VT; No ->SVT Differential Diagnosis: Supraventricular Tachycardia Study: Circulation. 1991 May;83(5):1649-59. PMID: 2022022 Acad Emerg Med. 2000 Jul;7(7):769-73. PMID: 10917326

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
History of CHF	24%	100%	Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
History of MI	66%	95%	Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075

Sensitive Findings

Finding	Sensitivity	Specificity	Comments, Study
Age	92%	54%	age > 35 Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
Gender	90%	27%	male Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075