Is it VT or SVT with aberrancy?
Capture/ Fusion Beats → VT
- If you see a normal-looking beat (capture) or hybrid beat (fusion) in a wide complex rhythm, it’s VT
AV Dissociation → VT
- Look for more QRS than P waves or P waves marching through → favors VT
Extreme Axis (Northwest Axis) → VT
- QRS negative in both I and aVF (or all precordials) OR if + in aVR = strong VT clue
QRS Morphology (Concordance) → VT
- All chest leads (V1–V6) either all positive or all negative = VT
History
- Structural heart disease, age >50, or prior MI → most likely VT
- Young, healthy, known SVT history → SVT with aberrancy more likely
