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Brugada Criteria (VT)

Differentiate VT from SVT with aberrant conduction in wide complex tachycardia. Applied to a 12-lead ECG during the tachycardia.

Indication

  • Differentiate VT from SVT with aberrant conduction in wide complex tachycardia. Applied to a 12-lead ECG during the tachycardia.

Criteria

  • id: step1; label: Step 1: Absence of RS complex in ALL precordial leads (V1–V6)?; type: yesno; points: 1
  • id: step2; label: Step 2: RS interval >100ms in any precordial lead?; type: yesno; points: 1
  • id: step3; label: Step 3: AV dissociation present?; type: yesno; points: 1
  • id: step4; label: Step 4: Morphology criteria for VT met in V1–V2 AND V6?; type: yesno; points: 1

Clinical pearls

  • Sensitivity 99% / specificity 97% in the original validation — the most commonly used criteria
  • Steps 1 and 3 (AV dissociation — cannon A waves, fusion/capture beats) are most useful in practice
  • If hemodynamically unstable, do not waste time on criteria — cardiovert immediately
  • Verapamil and diltiazem are contraindicated if VT cannot be excluded — may cause collapse

Source and review

  • Brugada P et al. Circulation 1991. Last reviewed: 2025-01-01