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Lead aVR on EKG
Lead aVR can provide some unique insight into 5 different conditions:

 - Acute
Lead aVR on EKG ... Lead aVR can provide ... TCA-like overdose - AVRT ... Differentiating VT ... EKG #ECG #Lead #AVR
Lead AVR on ECG
1. Acute myocardial infarction: ST elevation > 1.5 mm in aVR, indicative of
Lead AVR on ECG ... elevation > 1.5 mm in aVR ... PR elevation in aVR ... ventricular tachycardia (VT ... and to detect VT
Algorithm for the Evaluation of Regular, Wide-Complex Tachycardia
1. aVR: Is the initial deflection in aVR positive?
Tachycardia 1. aVR ... deflection in aVR ... If yes, then VT. ... If yes, then VT. ... If yes, then VT.
Vereckie Algorithm - Lead aVR - Ventricular Tachycardia - Telemetry Diagnosis
WCT is VT IF:
 • Initial
Algorithm - Lead aVR ... Diagnosis WCT is VT ... Tachycardia #WCT #VTach #avr
Approach to ECGs - VT vs. SVT - Wide Tachycardias
DDx = VT vs. SVT with BBB
All
Approach to ECGs - VT ... sensitive for VT ... is positive in aVR ... negative in I + aVF ... (> 160ms) - AV
Anatomical Differential Diagnosis for Arrhythmias
 • SA node: Sinus bradycardia, Sick Sinus Syndrome (SSS)
 • AV
Syndrome (SSS) • AV ... tachycardia (AVRT ... tachycardia (V-tach, VT ... ), Monomorphic VT ... , Polymorphic VT
Tachycardia - Differential Diagnosis Framework
Narrow-Complex:
 • Regular: Sinus Tachycardia, Junctional Tachycardia, Atrial Tachycardia, Atrial Flutter, AVRT
Atrial Flutter, AVRT ... Tachycardia, Antidromic AVRT ... Irregular: Polymorphic VT
Arrhythmias - Differential Diagnosis Algorithm

Bradyarrhythmia (<60 bpm)
 • Sinus Bradycardia
 • Sick Sinus Syndrome
 • SA
• SA Block • AV ... AVNRT • AVRT ... with Variable AV ... • Monomorphic VT ... • Polymorphic VT
Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
 • Vasovagal
 • Orthostatic Hypotension
 • Autonomic Neuropathy
 • Situational (micturition,
Tachyarrhythmia: • VT ... • AVNRT/AVRT ... 2nd/3rd degree AV
Tachycardia - Differential Diagnosis and Management - Narrow vs Wide, Regular vs Irregular
Narrow - Regular:
Use P
deflection not AVRT ... Regular: Assume VT