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

Population / Calculator	Prevalence	Comments / Study / Link
patients with wide-complex tachycardia	74%	Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
patients with wide-complex tachycardia and history of MI	98%	Ann Intern Med. 1988 Dec 1;109(11):905-12. PMID: 3190044
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The sensitivity and specificity of findings for Ventricular Tachycardia are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Brugada Criteria	+ 0 -	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	Result	Sensitivity	Specificity
[ + ] History of CHF	+ 0 -	24%	100%
Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
[ + ] History of MI	+ 0 -	66%	95%
Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075

Sensitive Findings
Finding	Result	Sensitivity	Specificity
[ + ] Age	+ 0 -	92%	54%
age > 35 Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
[ + ] Gender	+ 0 -	90%	27%
male Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075