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Differential entrainment distinguishes atrioventricular nodal reentry tachycardia from atrioventricular reentrant tachycardia.

Authors: Aamir H, Khan; Aliasghar, Khadem; Magdy N, Basta; Martin J, Gardner; Ratika, Parkash; Lorne J, Gula; John L, Sapp;

Differential entrainment distinguishes atrioventricular nodal reentry tachycardia from atrioventricular reentrant tachycardia.

Abstract

Entrainment from the right ventricular (RV) apex and the base has been used to distinguish atrioventricular reentrant tachycardia (AVRT) from atrioventricular nodal reentry tachycardia (AVNRT). The difference in the entrainment response from the RV apex in comparison with the RV base has not been tested.Fifty-nine consecutive patients referred for ablation of supraventricular tachycardia (SVT) were included. Entrainment of SVT was performed from the RV apex and base, pacing at 10-40-ms faster than the tachycardia cycle length. SA interval was calculated from stimulus to earliest atrial electrogram. Ventricle to atrium (VA) interval was measured from the RV electrogram (apex and base) to the earliest atrial electrogram during tachycardia. The SA-VA interval from apex and base was measured and the difference between them was calculated.Thirty-six AVNRT and 23 AVRT patients were enrolled. Mean age was 44 ± 12 years; 52% were male. The [SA-VA]apex-[SA-VA]base was demonstrable in 84.7% of patients and measured -9.4 ± 6.6 in AVNRT and 10 ± 11.3 in AVRT, P < 0.001. The difference was negative for all AVNRT cases and positive for all septal accessory pathways (APs).The difference between entrainment from the apex and base is readily performed and is diagnostic for all AVNRTs and septal APs.

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Keywords

Adult, Male, Middle Aged, Accessory Atrioventricular Bundle, Diagnosis, Differential, Electrocardiography, Heart Conduction System, Catheter Ablation, Tachycardia, Supraventricular, Humans, Tachycardia, Atrioventricular Nodal Reentry, Female

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Average
Average
Top 10%
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