Brugada Criteria for Ventricular Tachycardia
Patients with wide QRS-complex tachycardias (WCT).
- When none of the VT criteria is present, VT is still present in 15% of cases (Jastrzebski 2016). If there is doubt, the patient should be treated for VT.
- Using only the first two steps has been shown to yield an 81-96% positive predictive value for VT (Garner 2013).
- Although Brugada initially reported an accuracy of 98%, four subsequent studies have found accuracies ranging from 77-85%.
- May have limited agreement among physicians (in one study, up to 22% of emergency physicians disagreed on EKG interpretation using the criteria).
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Because current EKG algorithms misdiagnose WCTs 10% of the time (Grimm 1996), knowledge of diagnostic algorithms like the Brugada Criteria is important.
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The algorithm uses a stepwise approach to provide a sensitive, specific, and accurate way of differentiating SVT with aberrant conduction from VT.
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Using a stepwise approach prevents errors from being made in the differential diagnosis of tachycardias with a wide QRS complex.
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Compared to other criteria, this criteria is less prone to mistakes causing potentially fatal outcomes.
Result:
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About the Creator
Pedro Brugada, MD, PhD, is head of the cardiac arrhythmia unit at Hospital Estepona and the Heart Rhythm Management Centre at Brussels University Hospital in Brussels, Belgium. He has received the Gold Medal of the European Society of Cardiology for his work in cardiac arrhythmias. Dr. Brugada's primary research interests involve rhythmology and electrophysiology, and he has published over a thousand peer-reviewed articles and abstracts.
To view Dr. Pedro Brugada's publications, visit PubMed
- John Dayton, MD