Among patients with wide-complex tachycardia, what are the clues to help distinguish between ventricular tachycardia (VT) versus supraventricular tachycardia (SVT) with aberrancy?
|Presenting symptoms||Not Helpful|
|History of CAD and previous MI||VT|
|Carotid sinus massage/adenosine terminate arrhythmia||SVT*|
|Capture or fusion||VT|
|QRS width>140 msec||VT|
|Extreme axis deviation
(left or right superior axis)
|Positive QRS concordance
(R wave across chest leads)
|Negative QRS concordance
(S wave across chest leads)
|may suggest VT|
|Axis shift during arrhythmia||VT (polymorphic)|
*if patient >65 and previous MI or structural heart disease, then chance of VT is >95%.