The DOI matches its Crossref record; 7 of the 7 references it cites were found in a registry or an index.
A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex
Abstract
BACKGROUND: In the differential diagnosis of a tachycardia with a wide QRS complex (greater than or equal to 0.12 second) diagnostic mistakes are frequent. Therefore, we investigated the reasons for failure of presently available criteria, and we identified new, simpler criteria and incorporated them in a stepwise approach that provides better sensitivity and specificity for making a correct diagnosis. METHODS AND RESULTS: A prospective analysis revealed that current criteria had a poor specificity for the differential diagnosis. The value of four new criteria incorporated in a stepwise approach was prospectively analyzed in a total of 554 tachycardias with a widened QRS complex (384 ventricular and 170 supraventricular). The sensitivity of the four consecutive steps was 0.987, and the specificity was 0.965. CONCLUSIONS: Current criteria for the differential diagnosis between supraventricular tachycardia with aberrant conduction and ventricular tachycardia are frequently absent or suggest the wrong diagnosis. The absence of an RS complex in all precordial leads is easily recognizable and highly specific for the diagnosis of ventricular tachycardia. When an RS complex is present in one or more precordial leads, an RS interval of more than 100 msec is highly specific for ventricular tachycardia. This new stepwise approach may prevent diagnostic mistakes.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The morphology criteria are not fulfilled in any lead in 4% of SVTs and 6% of VTs, and in a third of cases when one lead (V 1 or V 6 ) favours one diagnosis, the other one favours the opposite diagnosis (VT in one lead and SVT the other one and vice versa).59”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [59]
In the citing paper
“The Brugada et al. algorithm, when all 4 steps are applied, has a sensitivity and specificity of 98.7% and 96.5%, respectively.59”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [59]
Citations
Cites
Wellens, H. J. J., Bär, F. W. H. M., & Lie, K. I. (1978) · The American Journal of Medicine · doi:10.1016/0002-9343(78)90176-6 · Cited by 538
Wide Complex Tachycardia: Misdiagnosis and Outcome After Emergent Therapy
Stewart, R. B., BARDY, G. H., & GREENE, H. L. (1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-104-6-766 · Cited by 259
Kindwall, K. E., Brown, J., & Josephson, M. E. (1988) · The American Journal of Cardiology · doi:10.1016/0002-9149(88)91169-1 · Cited by 253
Marriott, H. J. L., & Sandler, I. A. (1966) · Progress in Cardiovascular Diseases · doi:10.1016/s0033-0620(66)80019-1 · Cited by 94
A Prevalent Misconception Regarding Wide-Complex Tachycardias
Morady, F. (1985) · JAMA · doi:10.1001/jama.1985.03360190096032 · Cited by 81
Wellens, H. J. J., Bär, F. W. H. M., Vanagt, E. J., Brugada, P., & Farré, J. (1981) · Springer eBooks · doi:10.1007/978-94-009-8239-0_11 · Cited by 75
Kistin, A. D. (1966) · Progress in Cardiovascular Diseases · doi:10.1016/s0033-0620(66)80018-x · Cited by 56
Flagged first, then by citations
Cited by
Sorted by citations
Items 701–737 of 737
Martins, R. P. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_40
Muresan, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_3
Mada, R. O. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_13
Schiau, S. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_32
Daval, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_31
Rosu, R. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_36
Puiu, M. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_11
Diene, L. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_33
Rosu, R. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_49
Guşetu, G. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_8
Daval, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_44
Muresan, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_15
EKG: Interpretation von Breitkomplextachykardien
Ruppert, J. P., & Körtl, T. (2026) · retten! · doi:10.1055/a-2322-4235
Acute Management of Dysrhythmias
Desai, K. M. (2026) · Techniques in vascular and interventional radiology · doi:10.1016/j.tvir.2026.101110
Regular wide complex tachycardia: Sheep in Wolf's clothing
Madapati, S. K., Akkineni, K. P., Katta, E., & Akkineni, M. P. (2026) · Indian Pacing and Electrophysiology Journal · doi:10.1016/j.ipej.2026.02.015
He, J., Wu, Z., & Liu, Z. (2026) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.70155
Comparative Diagnostic Performance of Wide QRS Tachycardia Algorithms in Dogs:
GOMES, I. D. O., Santana, J. L. D. S., Moura, L. D. S., Marques, D. C., Souza, Y. B., Rodrigues, R. P. D. S., Oliveira, E. A. L., & Alves, F. R. (2026) · ACTA SCIENTIAE VETERINARIAE · doi:10.22456/1679-9216.150958
Posicionamento sobre Diagnóstico e Tratamento da Tempestade Elétrica – 2026
Soeiro, A. D. M., Pisani, C. F., Petriz, J. L. F., Gomes, B. F. D. O., das Virgens, C. M. B., Filho, J. R. D. O. S., Soares, P. R., Leal, T. D. C. A. T., Fagundes, A. A., Armaganijan, L., et al. (2026) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20260215
Supraventricular Tachycardia or Ventricular Tachycardia: An Unexpected Diagnostic Clue
Roig, A., de Andrade, A. T., & Gonzalez, Y. P. (2026) · Circulation · doi:10.1161/circulationaha.126.080138
Yeo, T. C. (2026) · Springer eBooks · doi:10.1007/978-981-96-7667-5_2
Guşetu, G. (2025) · Springer eBooks · doi:10.1007/978-3-031-97030-6_47
Electrocardiographic Surprise in Wide Complex Tachycardia
Bhardwaj, A., Singh, S., Kritya, M., Sharma, V., Das, S., & Shamim, S. (2026) · JACC Case Reports · doi:10.1016/j.jaccas.2026.107007
Prasitlumkum, N., Kittiwongsopon, S., & Rattanawong, P. (2026) · Cureus · doi:10.7759/cureus.109414
Comment on Brugada syndrome following acute bupropion overdose in a pediatric patient
Carroll, D. K., Paredes-Flores, M., & Vohra, V. (2026) · Clinical Toxicology · doi:10.1080/15563650.2026.2670709
“…in V2 are consistent with discrete P waves with a short rP interval. this is inconsistent with sinus or atrial tachycardia with aberrant conduction which should demonstrate a long rP interval (ie, rP > Pr interval) [4]. the rS interval in leads V5 and V6 exceeds 100 ms, also supporting Vt [5].”
Position Statement on the Diagnosis and Treatment of Electrical Storm – 2026
Soeiro, A. D. M., Pisani, C. F., Petriz, J. L. F., Gomes, B. F. D. O., das Virgens, C. M. B., Filho, J. R. D. O. S., Soares, P. R., Leal, T. D. C. A. T., Fagundes, A. A., Armaganijan, L., et al. (2026) · Arquivos Brasileiros de Cardiologia · doi:10.36660/abc.20260215i
Tremor Artifact Presenting as Pseudo-Ventricular Tachycardia
Haiy, A. U., Basit, M. A., Mirza, H. M., Wasim, A., Jalil, A., & Bajwa, A. (2026) · JACC Case Reports · doi:10.1016/j.jaccas.2026.108029
Wide Complex Tachycardia of Uncertain Origin
Khattab, A. R., Timmerman, C., Kee, A., Okada, D., & Khattab, M. (2026) · JACC Case Reports · doi:10.1016/j.jaccas.2026.108594
Schläpfer, J. (2000) · Cardiovascular Medicine · doi:10.3390/cardiovascmed3020020
“L’algorithme suivant (figure 3) a été proposé par les frères Brugada et leurs collaborateurs en 1991 (9) .”
Exercise-Provoked Wide-Complex Tachycardia and Extreme Duke Score
Ray, N., Petty, A. H., Money, D., & Bracewell, N. J. (2026) · JACC Case Reports · doi:10.1016/j.jaccas.2026.109337
Baghdadi, L., Zimmermann, M., & Reynard, C. (2001) · Cardiovascular Medicine · doi:10.3390/cardiovascmed4030038
Ventricular Tachycardia or Not?
Kaiwan, O., Budharaju, K., Vinod, P., Pushparaji, B., Nelson, M., Cunningham, C., & Almahameed, S. (2026) · JACC Case Reports · doi:10.1016/j.jaccas.2026.108549
Differential diagnosis of wide-complex tachycardia: ventricular or supraventricular?
Bordignon, S., Rudic, B., Kohls, A. L., Sönksen, N. M., Würfel, S., Götsch, B., & Hink, U. (2026) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-026-01163-4
Man in his 40s with a sudden onset of palpitations
Khan, R., & Shahid, M. (2026) · Emergency Medicine Journal · doi:10.1136/emermed-2025-215665
Limpitikul, W. B., Grewal, V., Hucker, W. J., Bapat, A. C., & Khurshid, S. S. (2026) · HeartRhythm Case Reports · doi:10.1016/j.hrcr.2026.10.002
Palpitations and dizziness in a 65-year-old man.
Wilde, A. A. M. (2006) · PubMed Central
Herzrhythmusstörungen in der Intensivmedizin
Zink, W. (2014) · Springer eBooks · doi:10.1007/978-3-642-44933-8_33
Herzrhythmusstörungen in der Intensivmedizin
Fresenius, M., & Heck, M. (2011) · Springer eBooks · doi:10.1007/978-3-642-16879-6_34
Metadata
- Authors
- Brugada, P., Brugada, J., Mont, L., Smeets, J., & Andries, E. W.
- Affiliations
- Onze Lieve Vrouwziekenhuis Hospital (BE)
- Venue
- Circulation
- Published
- 1991-05
- Volume
- 83
- Issue
- 5
- Pages
- 1649-1659
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2026083345
- Cited by
- 738
- References
- 7
- Citations by year
- 2026: 20 · 2025: 63 · 2024: 32 · 2023: 32 · 2022: 32 · 2021: 26 · 2020: 42 · 2019: 30 · 2018: 22 · 2017: 44 · 2016: 20 · 2015: 26 · 2014: 21 · 2013: 31 · 2012: 22
- FWCI
- 6.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- wide QRS tachycardia, differential diagnosis, ventricular tachycardia, supraventricular tachycardia with aberrancy, precordial leads, diagnostic criteria, sensitivity and specificity
- MeSH terms
- Diagnosis, Differential, Electrocardiography, Humans, Prospective Studies, Sensitivity and Specificity, Tachycardia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
