Brugada Criteria for Ventricular Tachycardia

Stepwise ECG algorithm distinguishing ventricular tachycardia from SVT with aberrancy.

Step 1: Absence of an RS complex in all precordial leads (V1-V6)

Step 2: RS interval >100 ms in any precordial lead (wider R than S)

Step 3: AV dissociation present

Step 4: Morphology criteria for VT met in both V1-2 and V6

ResultSVT with aberrancy favored

None of the four sequential Brugada criteria for VT were met.

Diagnosis: Supraventricular tachycardia with aberrancy

When to use

Differentiating ventricular tachycardia from supraventricular tachycardia with aberrant conduction in a regular wide-QRS tachycardia.

Formula

Applied sequentially, stopping at the first positive step: (1) absent RS in all precordial leads; (2) RS interval >100ms in any precordial lead; (3) AV dissociation; (4) morphology criteria for VT present in both V1-2 and V6. Any positive step diagnoses VT.

Pearls and pitfalls

Derived in regular wide-QRS tachycardias only; not intended for irregular rhythms such as atrial fibrillation with aberrancy or pre-excitation.

References

Brugada P, Brugada J, Mont L, Smeets J, Andries EW. A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex. Circulation. 1991;83(5):1649-59.