Document Detail


His Overdrive Pacing During Supraventricular Tachycardia: A Novel Maneuver for Distinguishing Atrioventricular Nodal Reentrant Tachycardia from Atrioventricular Reciprocating Tachycardia.
MedLine Citation:
PMID:  24793458     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Because the His bundle is intrinsic to the circuit in ORT and remote from that of AVNRT, pacing the His bundle during supraventricular tachycardia (SVT) may be useful to distinguish these arrhythmias OBJECTIVE: We tested the hypothesis that His Overdrive Pacing (HOP) would affect SVT immediately for ORT and in a delayed manner for AVNRT.
METHODS: Once SVT was induced, HOP was performed by pacing the His bundle 10-30 ms faster than the SVT cycle length. The maneuver was determined to have entered the tachycardia circuit when a non-fused his-capture beat advanced or delayed the subsequent atrial electrogram by ≥ 10 ms or when the tachycardia was terminated. The number of beats required to enter each tachycardia with HOP was recorded.
RESULTS: HOP was performed during 66 SVT's (26 AVRT and 40 AVNRT). Entry into the tachycardia within 1 beat had a sensitivity of 92%, specificity of 92%, positive predictive value (PPV) of 89% and a negative predictive value (NPV) of 95% to confirm the diagnosis of AVRT. A cutoff of ≥ 3 beats to enter the circuit had a sensitivity of 90%, Specificity of 92%, PPV of 95% and NPV of 86% to confirm the diagnosis of AVNRT. HOP had a sensitivity, specificity, PPV and NPV of 100% for distinguishing septal AVRT from atypical AVNRT.
CONCLUSIONS: HOP during SVT is a novel technique for distinguishing ORT from AVNRT. It can reliably distinguish between these arrhythmias with high sensitivity and specificity.
Authors:
David K Singh; Mohan N Viswanathan; Ronn E Tanel; Randall J Lee; Byron K Lee; Gregory M Marcus; Jeffrey E Olgin; Frederick Han; Vasanth Vedantham; Zian H Tseng; Cara Pellegrini; Mitsuharu Kawamura; Edward P Gerstenfeld; Nitish Badhwar; Melvin Scheinman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-30
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-5-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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