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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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Tags: Cardiac Problem Tag this Diagnosis.

Differential Diagnoses include: Supraventricular Tachycardia

Prevalence

Population / CalculatorPrevalence 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.

History

Finding SensitivitySpecificity Comments, Study
Age Edit 92%54%

age > 35

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

History of MI Edit 66%95%

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

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Finding SensitivitySpecificity Comments, Study
Brugada Criteria Edit 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

    Gender Edit 90%27%

    male

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

    History of CHF Edit 24%100%

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