| PR/RR interval ratio during rapid atrial pacing: a simple method for confirming the presence of slow AV nodal pathway conduction. | |
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MedLine Citation:
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PMID: 8777476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Although the AV conduction curve in patients with AV nodal reentrant tachycardia (AVNRT) is usually discontinuous, many patients with this arrhythmia do not demonstrate criteria for dual AV nodal pathways. During rapid atrial pacing, the PR interval often exceeds the pacing cycle length when there is anterograde conduction over the slow pathway and AVNRT is induced. The purpose of this prospective study was to determine the diagnostic value of the ratio of the PR interval to the RR interval during rapid atrial pacing as an indicator of anterograde slow pathway conduction in patients undergoing electrophysiologic testing. METHODS AND RESULTS: The PR and RR intervals were measured during rapid atrial pacing at the maximum rate with consistent 1:1 AV conduction in four study groups: (1) patients with inducible AV nodal reentry and the classical criterion for dual AV nodal pathways during atrial extrastimulus testing (AVNRT Group 1); (2) patients with inducible AV nodal reentry without dual AV nodal pathways (AVNRT Group 2); (3) control subjects < or = 60 years of age without inducible AV nodal reentry; and (4) control subjects > 60 years of age without inducible AV nodal reentry. For both groups of patients with inducible AV nodal reentry, AV conduction was assessed before and after radiofrequency ablation of the slow AV nodal pathway. Before slow pathway ablation, the PR/RR ratio exceeded 1.0 in 12 of 13 AVNRT Group 1 patients (mean 1.27 +/- 0.21) and 16 of 17 AVNRT Group 2 patients (mean 1.18 +/- 0.15, P = NS Group 1 vs Group 2). After slow pathway ablation, the maximum PR/RR ratio was < 1.0 in all AVNRT patients (Group 1 = 0.59 +/- 0.08, P < 0.00001 vs before ablation; Group 2 = 0.67 +/- 0.11; P < 0.00001 vs before ablation). Among both groups of control subjects, the PR/RR ratio was > 1.0 in only 3 of 27 patients with no relation to patient age. CONCLUSION: The ratio of the PR interval to the RR interval during rapid atrial pacing at the maximum rate with consistent 1:1 AV conduction provides a simple and clinically useful method for determining the presence of slow AV nodal pathway conduction. This finding may be particularly useful in patients with inducible AV nodal reentry without dual AV nodal physiology on atrial extrastimulus testing. |
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Authors:
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J H Baker; V J Plumb; A E Epstein; G N Kay |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 7 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 1996 Apr |
Date Detail:
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Created Date: 1996-09-19 Completed Date: 1996-09-19 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 287-94 Citation Subset: IM |
Affiliation:
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University of Alabama at Birmingham 35294, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aging / physiology Atrioventricular Node / physiopathology* Cardiac Pacing, Artificial* Electrocardiography Electrophysiology Female Heart Atria / physiopathology Heart Conduction System / physiopathology* Heart Rate / physiology* Humans Male Middle Aged Prospective Studies Tachycardia, Atrioventricular Nodal Reentry / diagnosis*, physiopathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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