Griffith Algorithm (VT vs SVT, default-to-VT)

Griffith algorithm (Lancet 1994) for wide-complex tachycardia.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Bundle branch pattern
Right bundle pattern (V1 mainly positive)
rSR prime in V1
Yes

Result: Griffith: VT by default - the right bundle pattern is not textbook (RS in V6 with R taller than S).

The tool opens with these values already filled in. Replace them with your own.

What the result means

Default
VT unless the QRS is a textbook bundle branch block. This is the reverse of Brugada and Vereckei, which look for features of VT.
Right bundle
SVT only if BOTH: rSR prime in V1, and RS in V6 with the R taller than the S.
Left bundle
SVT only if ALL THREE: rS or QS in V1 and V2; delay to the S nadir under 70 ms; an R wave in V6 with no Q wave.
Performance
Sensitivity for VT about 94%, specificity about 40%. VT here is a safe default, not a positive finding; RVOT tachycardias are known to be misread as SVT.
Caution
An unstable wide-complex tachycardia is treated as VT and cardioverted regardless of any algorithm.

What you enter

  • Bundle branch pattern
  • rSR prime in V1 (right bundle)
  • RS in V6, R taller than S (right bundle)
  • rS or QS in V1 and V2 (left bundle)
  • S nadir under 70 ms (left bundle)
  • R with no Q in V6 (left bundle)
How this is calculated

Griffith MJ, Garratt CJ, Mounsey P, Camm AJ. Ventricular tachycardia as default diagnosis in broad complex tachycardia. Lancet. 1994;343(8894):386-388. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.