Document Detail

Entrainment from the para-Hisian region for differentiating atrioventricular node reentrant tachycardia from orthodromic atrioventricular reentrant tachycardia.
MedLine Citation:
PMID:  18776198     Owner:  NLM     Status:  MEDLINE    
AIMS: The difference between the stimulus-atrial and ventriculo-atrial intervals (SA-VA) and between the post-pacing interval and the tachycardia cycle length (PPI-TCL) during entrainment from the right ventricular apex distinguishes atrioventricular node reentrant (AVNRT) from orthodromic atrioventricular reentrant tachycardia (AVRT). We hypothesized that these features still apply when entrainment is performed from the para-Hisian region. METHODS AND RESULTS: Forty-seven supraventricular tachycardias (34 AVNRT/13 AVRT) were included. The SA-VA and PPI-TCL were obtained in all patients by using two right-sided diagnostic catheters. In 24 of them, these measurements were also performed upon His-bundle capture during entrainment. A paced QRS widening of >or=40 ms during entrainment, when compared with the tachycardia QRS width, identified absence of His-bundle capture, P < 0.001. A SA-VA >75 ms distinguished AVNRT from AVRT, P < 0.001 (sensitivity/specificity 97%/100%). A PPI-TCL >100 ms was diagnostic of AVNRT, P < 0.001 (sensitivity/specificity 97%/92%). Upon His-bundle capture, the SA-VA and PPI-TCL shortened in AVNRT (121 +/- 23 to 66 +/- 24 ms; 139 +/- 30 to 85 +/- 31 ms, respectively, P < 0.001) and no longer differentiated AVNRT from AVRT. CONCLUSION: Para-Hisian entrainment without His-bundle capture distinguishes AVNRT from AVRT with the advantage of using only two diagnostic catheters.
Jordi Pérez-Rodon; Victor Bazan; Jordi Bruguera-Cortada; Sergi Mojal-García; Josep M Manresa-Domínguez; Julio Martí-Almor
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Publication Detail:
Type:  Journal Article     Date:  2008-09-05
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-25     Completed Date:  2009-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1205-11     Citation Subset:  IM    
Electrophysiology Unit, Cardiology Department, Hospital del Mar, IMAS, 25 Passeig Marítim, 08003 Barcelona, Spain.
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MeSH Terms
Body Surface Potential Mapping / methods*
Bundle of His*
Cardiac Pacing, Artificial / methods*
Diagnosis, Differential
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Tachycardia, Atrioventricular Nodal Reentry / classification,  diagnosis*,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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