کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2923462 1175874 2010 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
A novel approach to differentiating orthodromic reciprocating tachycardia from atrioventricular nodal reentrant tachycardia
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
A novel approach to differentiating orthodromic reciprocating tachycardia from atrioventricular nodal reentrant tachycardia
چکیده انگلیسی

BackgroundVarious diagnostic maneuvers have been proposed to help differentiate orthodromic reciprocating tachycardia (ORT) from atrioventricular nodal reentrant tachycardia (AVNRT) prior to ablation. However, not all criteria are applicable in every situation as each has limitations.ObjectiveThe purpose of this study was to determine whether the behavior of tachycardia during onset of right ventricular (RV) pacing would help differentiate ORT from AVNRT.MethodsWe retrospectively reviewed 72 cases (42 typical AVNRT, 7 atypical AVNRT, 15 left free-wall pathways, 6 septal pathways, 2 right free-wall pathways). We assessed the number of beats required to accelerate the tachycardia cycle length (TCL) to the paced cycle length (PCL) once a fully RV paced complex was achieved during supraventricular tachycardia.ResultsIn the AVNRT group, delta cycle length (DCL = PCL-TCL) was 29 ± 16 ms compared to 29 ± 10 ms in ORT group (P = NS). In the AVNRT group, the average number of fully RV paced beats required to reset the tachycardia was 3.7 ± 1.1 compared to 1 ± 0 in the ORT group (P <.0001). Using a cutoff >1 beat yielded both positive and negative predictive values of 100% for diagnosing AVNRT versus ORT. During entrainment attempts, AVNRT terminated 51% of the time and ORT terminated 65% of the time but still allowed application of the new criterion.ConclusionAssessing timing and type of response of supraventricular tachycardia to RV pacing can help differentiate ORT from AVNRT with high certainty and prevent the need for other pacing maneuvers and measurements.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Heart Rhythm - Volume 7, Issue 9, September 2010, Pages 1326–1329
نویسندگان
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