Differentiating Ventricular Tachycardia from Wide-Complex Supraventricular Arrhythmias

Authors

• Jevon Gegg-Mitchell, University of LynchburgFollow

Specialty

Hematology/Oncology

Advisor

Thomas Colletti

Abstract

Among hospitalized patients, one of the most consequential cardiac telemetry findings is wide-complex arrhythmias of potential ventricular origin. Differentiating between true ventricular tachycardia (VT) and supraventricular wide-complex tachycardia (SWCT) can be challenging but is extremely important given the acute need to manage such patients correctly and expeditiously. The purpose of this paper is to review techniques for differentiating between VT and SWCT, with an emphasis on strategies that can easily be employed by hospitalists and other general practice clinicians. A literature review yielded several techniques for determining the origin of wide-complex tachycardias including atrioventricular dissociation, precordial lead concordance, and QRS morphology. Additional factors such as QRS duration and regularity versus irregularity of the underlying rhythm were also helpful for determining true ventricular origin versus SWCT. Past electrocardiographic tracings can be helpful for comparison, but the clinician should endeavor to interpret each electrocardiogram objectively and avoid anchoring on past interpretations.

Recommended Citation

Gegg-Mitchell J. Differentiating Ventricular Tachycardia from Wide-Complex Supraventricular Arrhythmias. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).