Ventricular tachycardia score - A novel method for wide QRS complex tachycardia differentiation - Explained

Philosophy, merits and limitations of a novel method for wide QRS complex tachycardia differentiation, based on a scoring system and called the ventricular tachycardia (VT) score, were explained. The following criteria were assigned one point: initial dominant R wave in V1; initial r>40 ms in V1 or V2; notched S in V1; initial R wave in aVR; lead II RWPT≥50 ms; and absence of an RS in leads V1-V6. Atrioventricular dissociation (including fusion/capture beats and partial dissociation) was assigned two points. We recommend ≥3 VT score points for a firm diagnosis of VT. A cut-off ≥1 point can be used for diagnosis of VT when highest overall accuracy rather than error-free diagnosis is desired. However, in case of VT score of 0-2 (i.e., not fully diagnostic ECG), we recommend using other options (electrophysiological study, clinical data, previous and following ECGs, etc.) for confirming the diagnosis.