[Value of old and new electrocardiography criteria for differential diagnosis between ventricular tachycardia and supraventricular tachycardia with bundle branch block]

Abstract

In 240 tachycardias with wide QRS-complex (> or = 120 ms), the value of the "old" ECG criteria published in 1978 by Wellens and coworkers was compared to the "new" ECG criteria published in 1991 by Brugada and coworkers for the differential diagnosis of tachycardias with wide QRS-complex. As main result of the study, it could be demonstrated that with the old as well as with the new ECG criteria a sensitivity of more than 90% for the correct diagnosis ventricular tachycardia can be reached. The specificity of the old and new ECG criteria for the diagnosis ventricular tachycardia is 70% and 72% for tachycardias with right bundle branch block configuration and 87% each for tachycardias with left bundle branch block configuration. The combined use of the old and the new ECG criteria in this study could not increase sensitivity and specificity for the diagnosis of ventricular tachycardia. Therefore, it does not appear to be important for the differential diagnosis of tachycardias with wide QRS-complex whether the old or the new step diagnostic criteria are being used, but that either the old or the new ECG criteria are being used correctly.