A stepwise approach can be used in the evaluation of tachycardias with a wide QRS complex, thereby reducing the chance for errors in diagnosis.
Questions:
(1) Is there absence of an RS complex in all precordial leads?
(2) Is there an R-S interval > 100 msec in one precordial lead?
(3) Is atrio-ventricular dissociation present?
(4) Are morphologic criteria for ventricular tachycardia present in both (a) precordial leads V1 or V2, and (b) V6?
|
Q(1) |
Q(2) |
Q(3) |
Q(4) |
Diagnosis |
Cumulative Sensitivity |
Cumulative Specificity |
|
Yes |
|
|
|
ventricular tachycardia |
21% |
100% |
|
No |
Yes |
|
|
ventricular tachycardia |
66% |
98% |
|
No |
No |
Yes |
|
ventricular tachycardia |
82% |
98% |
|
No |
No |
No |
Yes |
ventricular tachycardia |
98.7% |
96.5% |
|
No |
No |
No |
No |
supraventricular tachycardia with aberrant conduction |
96.5% |
98.7% |
Specialty: Cardiology
