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Morphological Criteria for Discriminating Ventricular Tachycardia from Supraventricular Tachycardia with Aberration

Source Article: Wide Complex Tachycardia –
Tachycardia #Aberration #Aberrancy
VT versus SVT with Aberration - Interpretation Cheat Sheet

Features favouring VT
● Absence of typical RBBB or
SVT #Aberration #Aberrancy
Wide Complex Tachycardia - Differential Diagnosis Algorithm
Irregular
 • Polymorphic VT
    - Torsades
• AFib with Aberrancy ... - SVT with Aberrancy
Tachycardia - Differential Diagnosis Framework
Narrow-Complex:
 • Regular: Sinus Tachycardia, Junctional Tachycardia, Atrial Tachycardia, Atrial Flutter, AVRT
Antidromic AVRT, SVT w/aberrancy ... irregular SVT w/ aberrancy
The 3 Fates of a Premature Atrial Complex
 • PAC can be conducted with normal QRS
conducted with aberrancy ... conducted with aberrancy
Causes of Tachycardia - Differential Diagnosis Algorithm
Narrow Complex - Regular:
 • Sinus tachycardia
 • Atrial flutter
Regular SVT with aberrancy ... Irregular SVT with aberrancy
Ventricular Tachycardia - Management Algorithm
Wide Complex Tachycardia: Rate > 100, QRS > 120
DDx: Ventricular tachycardia, SVT
tachycardia, SVT with aberrancy
Treatment of Stable Wide-Complex Tachycardia
Regular
 • If ventricular tachycardia or uncertain rhythm:
    -
known SVT with aberrancy ... • If AF with aberrancy
Arrhythmias - Differential Diagnosis Algorithm

Bradyarrhythmia (<60 bpm)
 • Sinus Bradycardia
 • Sick Sinus Syndrome
 • SA
with conduction aberrancy ... with conduction aberrancy
Lead aVR on EKG
Lead aVR can provide some unique insight into 5 different conditions:

 - Acute
from SVT with aberrancy