When the origin of a wide-complex tachycardia (VT vs. SVT with aberrant conduction) is uncertain, morphology-based algorithms such as the Brugada criteria evaluate features like AV dissociation, QRS morphology concordance across the precordial leads, and specific R-wave/S-wave timing relationships to favor a ventricular origin; in any hemodynamically unstable wide-complex tachycardia, treatment proceeds per the unstable tachycardia ACLS pathway regardless of the exact mechanism, since stabilization takes priority over precise diagnosis in the moment.
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