A novel approach to differentiating orthodromic reciprocating tachycardia from atrioventricular nodal reentrant tachycardia

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Gopi DandamudiJohn M Miller

Abstract

Various 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. The 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. We 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. In 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 t...Continue Reading

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Citations

Nov 27, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Krishnakumar NairKumaraswamy Nanthakumar
Oct 27, 2015·Pacing and Clinical Electrophysiology : PACE·Warangkna BoonyapisitKrit Jongnarangsin
Jun 20, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, Steven A Levi
Oct 2, 2015·Pacing and Clinical Electrophysiology : PACE·Rahul Jain, John M Miller
Sep 29, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Robert KimMark L Greenberg
Oct 18, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Manoj ObeyesekereGeorge J Klein
Dec 28, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Debjit Chatterjee
Jan 11, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Charalampos KriatselisJin-Hong Gerds-Li
Mar 1, 2013·Journal of Cardiovascular Electrophysiology·John M Miller, Waddah Maskoun
Jul 24, 2012·Pacing and Clinical Electrophysiology : PACE·Róbert Pap, László Sághy
Mar 29, 2011·Pacing and Clinical Electrophysiology : PACE·George D VeenhuyzenL Brent Mitchell
Aug 18, 2012·Pacing and Clinical Electrophysiology : PACE·Ashley ChinCarlos A Morillo
Feb 25, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mitsuharu KawamuraMelvin M Scheinman
Apr 2, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Demosthenes G Katritsis, Mark E Josephson
Mar 18, 2015·Current Treatment Options in Cardiovascular Medicine·Reginald T Ho
Nov 20, 2016·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·Demosthenes G KatritsisJack Rickard
May 1, 2013·Circulation. Arrhythmia and Electrophysiology·Reginald T HoArnold J Greenspon
Dec 5, 2014·Circulation. Arrhythmia and Electrophysiology·Kurt S HoffmayerMelvin M Scheinman
Jun 20, 2013·Circulation. Arrhythmia and Electrophysiology·Jennifer M WrightPeter A Santucci
Apr 5, 2019·Pacing and Clinical Electrophysiology : PACE·Yoshiaki KanekoMasahiko Kurabayashi
Dec 26, 2019·International Heart Journal·Yoshiaki KanekoMasahiko Kurabayashi
Dec 19, 2020·Journal of Cardiovascular Electrophysiology·Yoshiaki KanekoMasahiko Kurabayashi
Oct 5, 2021·Circulation. Arrhythmia and Electrophysiology·Mohan N ViswanathanMelvin M Scheinman

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