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

Anthony H. Kashou, Peter Noseworthy, Christopher V. DeSimone, Abhishek J. Deshmukh, Samuel J. Asirvatham, Adam M. May

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)e016598
JournalJournal of the American Heart Association
Volume9
Issue number11
DOIs
StatePublished - Jun 2 2020

Keywords

  • ECG
  • supraventricular tachycardia
  • ventricular tachycardia
  • wide complex tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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