Following the discussion on ectopy and aberrancy (view Ectopy or aberrancy? Google Ecg+ community comments on a clinical case.) Ken Grauer, EKG master and author of many EKG books, gave us the permission to share his “3 SIMPLE Rules” to recognize VT in a simple ad accurate way.
Rule #1 Is there extreme axis deviation during WCT
Extreme axis deviation is easy to recognize. The QRS complex will be entirely negative in either lead I or lead aVF. The presence of extreme axis deviation during a WCT rhythm is virtually diagnostic of VT.
Rule #2 Is lead V6 all (or almost all) negative?
IF ever the QRS in lead V6 is either all negative (or almost all negative) then VT is highly likely.
Rule #3 Is the QRS during WCT “ugly”?
The “uglier” the QRS the more likely the rhythm is. VT originates from a ventricular…
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