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<p>Wide-complex tachycardia (WCT) represents one of the most challenging diagnoses in clinical cardiology and emergency medicine, requiring rapid and accurate differentiation between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrant conduction. Misclassification carries significant clinical consequences, as the two entities differ substantially in prognosis and management. This review aims to provide a&#xa0;comprehensive overview of the electrocardiographic approach to the differential diagnosis of WCT, with particular focus on the physiological rationale underlying the diagnostic criteria included in the major diagnostic algorithms. A&#xa0;thorough understanding of these electrocardiographic principles remains essential for any physician encountering WCT in clinical practice.</p>

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Differential diagnosis of wide-complex tachycardia: ventricular or supraventricular?

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Stefano Bordignon,
  • Boris Rudic,
  • Alexander Langanke Kohls,
  • Nils Malte Sönksen,
  • Sara Würfel,
  • Benedikt Götsch,
  • Ulrich Hink

摘要

Wide-complex tachycardia (WCT) represents one of the most challenging diagnoses in clinical cardiology and emergency medicine, requiring rapid and accurate differentiation between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrant conduction. Misclassification carries significant clinical consequences, as the two entities differ substantially in prognosis and management. This review aims to provide a comprehensive overview of the electrocardiographic approach to the differential diagnosis of WCT, with particular focus on the physiological rationale underlying the diagnostic criteria included in the major diagnostic algorithms. A thorough understanding of these electrocardiographic principles remains essential for any physician encountering WCT in clinical practice.