Ectopy or aberrancy? Google Ecg+ community comments on a clinical case.

The question about ectopy and aberrancy, even if of minor influence on theraphy that was based on clinical presentation, was interestingly debated in ECG+ community.

Prof. Ken Grauer and other members of community gave the solution on why the above 12 leads EKG was, with good approximation, referrable to a VT and not to a SVT conducted with aberrancy.

Those are the EKG criteria they individuated:

1. Extreme axis “northwest axis”: (neg in lead I, positive in lead aVR);
2. Lead V1 is amorphous
3. Lead V6 is almost all negative
4. No diphasic RS complexes in any of the precordial leads
5. Monophasic R-wave in lead V1(taller left “rabbit-ear”)
6. Diphasic QR complexes in leads V2 and V3.
7. Monophasic QS complexes in leads V4, V5, and V6.
8. Josephson’s sign (notching on the nadir of S wave)

Those criteria, even if present in this case, are universally valid.

If you want to discover more on this topic MEDEST already posted on this topic in a previous post

There you can find alle the references on EKG criteria for differential diagnosis between ectopy and aberrancy in wide comples tachycardia.