Differentiating VT from Other Rhythms

So, how can we differentiate VT from these other rhythms?

  • Any patient with a history of ischaemic or structural heart disease should be assumed to have VT
  • A prior history of MI = 98% chance the rhythm is VT
  • History of structural heart disease = 90% chance the rhythm is VT [7]

This may save attempts at detailed ECG analysis.

Learning bite

  • In differentiating between VT and SVT with aberrant conduction – if the patient is >50 and/or has a history of structural or ischaemic heart disease, assume the rhythm is VT
  • If there is any doubt whatsoever – treat a regular broad complex tachychardia as VT