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Ventricular tachycardia (Brugada criteria) vs Atrial Flutter with regular block (Golden numbers)

6/7/2020

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Remember the ‘Golden Numbers’ - 75, 100, 150, 200.
Atrial Flutter 2:1 block can present as broad complex tachycardia at rate 150 if bundle branch block exists.
Be wary of rates that are perfectly regular with rates of 75, 100, 150, 200 - they may represent atrial flutter with a 4:1 or 3:1, 2:1 or 3:2 block.
Look for the p waves embedded in t waves.

Also remember Brugada criteria for VT (92-96% sensitive):

If no RS complex in V leads —— diagnose VT
If R to S nadir time is > 100ms ——— diagnose VT
If av dissociation ———————diagnose VT
If V1 and V6 morphology suggest VT - diagnose VT

If none of above ——— diagnose SVT with aberrancy.

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Ben Lepke
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