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Brugada algoritmus (KT vs. Aberantná SVT)

Brugada algorithm (ventricular tachycardia vs. SVT with aberrant conduction)

Peter Blahút
techmed@techmed.sk

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia, Brugada algorithm Wide complex tachycardia, SVT with aberrant conduction due to bundle branch block, RBBB, LBBB, Brugada algorithm Wide complex tachycardia, Orthodrome AV, SVT with aberrant conduction due to the Wolff-Parkinson-White (WPW) syndrome, Brugada algorithm
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Brugada algorithm, Differential Diagnosis of Wide-Complex Tachycardia

Široko-komplexová tachykardia má 3 hlavné príčiny


Brugada algoritmus (KT vs. Aberatná SVT)


Wide complex tachycardia, ventricular tachycardia Wide complex tachycardia, SVT with aberrant conduction due to bundle branch block, RBBB, LBBB Wide complex tachycardia, Orthodrome AV, SVT with aberrant conduction due to the Wolff-Parkinson-White (WPW) syndrome
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Differential Diagnosis of Wide-Complex Tachycardia, ventricular tachycardia

Široko-komplexová tachykardia

Brugada algoritmus v Klinickej praxi



Brugada algorithm, ECG criteria, diagnosis of wide QRS complex tachycardias, absence RS copmlex, RS interval, AV dissociation, Morphology (V1,V6) - RBBB and LBBB

Brugada algoritmus (1. časť)



Brugada algorithm, morphology criteria in precoridal leads V1, V6, LBBB shaped VT, RBBB shaped VT

Brugada algoritmus (2. časť)


Brugada algoritmus - Limitácie



ECG Brugada algorithm, RS complex in all precordial leads (NO) - Ventricular tachycardia

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia


ECG Brugada algorithm, AV dissociation, Fusion beat, Capture beat, Narrow complex fasciculer ventricular tachycardia

Úzko-komplexová tachykardia



Posterior fascicular ventricular tachycardia


ECG Brugada algorithm, RBBB morphology, extreme right axis deviation, Fascicular ventricular tachycardia, re-entry - left posterior fasciculus

Široko-komplexová tachykardia


Posterior fascicular ventricular tachycardia


ECG wide complex tachycardia, Brugada algorithm, RS interval 100ms (Yes), ventricular tachycardia

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia


ECG Brugada algorithm, RBBB morphology, normal heart axis, SVT (AVNRT) with aberrant conduction due to bundle branch block

Široko-komplexová tachykardia

  • Šírka QRS 0,14s
  • Frekvencia 212/min.
  • Brugada algoritmus (2.časť)
    • Typický obraz BPTR (pravé zajačie ucho je väčšie)
    • Srdcová os je normálna (Dominantné R v II zvode)
  • Ide o SVT s BPTR
    • Konkrétne o AVNRT s BPTR
AVNRT, SVT with aberrant conduction - RBBB


ECG Wide complex tachycardia, SVT with aberrant conduction, WPW syndrome, antidromic AVRT

Široko-komplexová tachykardia

Antidromic AVRT, SVT with aberrant conduction due to the Wolff-Parkinson-White (WPW) syndrome


ECG ventricular tachycardia RBBB morphology, Brugada algorithm No RS copmlex in precordial lead

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia


ECG wide complex tachycardia, Brugada algorithm, LBBB morphology, left axis deviation, SVT with LBBB tachycardia

Široko-komplexová tachykardia

  • Šírka QRS 0,18s
  • Frekvencia 165/min.
  • Brugada algoritmus (2. časť)
  • S najväčšou pravdepodobnosťou ide o SVT s BĽTR
    • Komorová tachykardia je menej pravdepodobná
LBBB, aberrant supraventricular tachycardia


ECG wide complex tachycardia, Brugada algorithm, RBBB morphology, right axis deviation, Supraventricular tachycardia with aberrant conduction - RBBB

Široko-komplexová tachykardia

  • Šírka QRS 0,14s
  • Frekvencia 158/min.
  • Brugada algoritmus (2. časť)
  • S najväčšou pravdepodobnosťou ide o SVT s BPTR
    • Komorová tachykardia je menej pravdepodobná

supraventricular tachycardia, RBBB


ECG wide complex tachycardia, Brugada algorithm, AV dissociation, Ventricular tachycardia

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia, ectopic focus


Wide complex tachycardia, Brugada algorithm, AV dissociation, RS complex - negative precordial concordance, ventricular tachycardia

Široko-komplexová tachykardia

Wide complex tachycardia, ventricular tachycardia, ectopic focus

Peter Blahút
techmed@techmed.sk