Wide Complex Tachycardia Differentiation: A Reappraisal of the State-of-the-Art

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2020 May 20

PMID 32427020

Citations 13

Authors

Anthony H Kashou

Peter A Noseworthy

Christopher V DeSimone

Abhishek J Deshmukh

Samuel J Asirvatham

Adam M May

Affiliations

Soon will be listed here.

Abstract

The primary goal of the initial ECG evaluation of every wide complex tachycardia is to determine whether the tachyarrhythmia has a ventricular or supraventricular origin. The answer to this question drives immediate patient care decisions, ensuing clinical workup, and long-term management strategies. Thus, the importance of arriving at the correct diagnosis cannot be understated and has naturally spurred rigorous research, which has brought forth an ever-expanding abundance of manually applied and automated methods to differentiate wide complex tachycardias. In this review, we provide an in-depth analysis of traditional and more contemporary methods to differentiate ventricular tachycardia and supraventricular wide complex tachycardia. In doing so, we: (1) review hallmark wide complex tachycardia differentiation criteria, (2) examine the conceptual and structural design of standard wide complex tachycardia differentiation methods, (3) discuss practical limitations of manually applied ECG interpretation approaches, and (4) highlight recently formulated methods designed to differentiate ventricular tachycardia and supraventricular wide complex tachycardia automatically.

Citing Articles

Dataset and analysis of automated and manual methods to differentiate wide QRS complex tachycardias.

LoCoco S, Kashou A, Deshmukh A, Asirvatham S, DeSimone C, Mikhova K Data Brief. 2025; 58:111198.

PMID: 39758517 PMC: 11698938. DOI: 10.1016/j.dib.2024.111198.

Automated differentiation of wide QRS complex tachycardia using QRS complex polarity.

May A, Katbamna B, Shaikh P, LoCoco S, Deych E, Zhou R Commun Med (Lond). 2024; 4(1):282.

PMID: 39741223 PMC: 11688452. DOI: 10.1038/s43856-024-00725-2.

Diagnosis and management of ventricular tachycardia.

Whitaker J, Wright M, Tedrow U Clin Med (Lond). 2023; 23(5):442-448.

PMID: 37775174 PMC: 10541285. DOI: 10.7861/clinmed.2023-23.5.Cardio3.

Mayo Clinic VT calculator: A practical tool for accurate wide complex tachycardia differentiation.

Kashou A, LoCoco S, Gardner M, Webb J, Jentzer J, Noseworthy P Ann Noninvasive Electrocardiol. 2023; 28(6):e13085.

PMID: 37670480 PMC: 10646384. DOI: 10.1111/anec.13085.

Computerized electrocardiogram data transformation enables effective algorithmic differentiation of wide QRS complex tachycardias.

Kashou A, LoCoco S, Shaikh P, Katbamna B, Sehrawat O, Cooper D Ann Noninvasive Electrocardiol. 2022; 28(1):e13018.

PMID: 36409204 PMC: 9833371. DOI: 10.1111/anec.13018.

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