Ventricular Tachycardia: Likelihood Ratios

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 likelihood ratios of findings for Ventricular Tachycardia are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding	+LR	-LR	Comments, Study
Brugada Criteria	28.2	0	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
Age	2	0.1	age > 35 Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075
History of MI	13.2	0.4	Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075

Good Negative Likelihood Ratio

Gender

1.2

0.4

male

Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075

Good Positive Likelihood Ratio

History of CHF

inf

0.8

Study: Ann Emerg Med. 1987 Jan;16(1):40-3. PMID: 3800075