Differentiating atrioventricular nodal reentrant tachycardia from atrioventricular reentrant tachycardia by DeltaHA values during entrainment from the ventricle

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Reginald T HoArnold J Greenspon

Abstract

Differentiating atrioventricular nodal reentrant tachycardia (AVNRT) from orthodromic atrioventricular reentrant tachycardia (AVRT) can be difficult. The His bundle and atria are activated sequentially over the AV node during entrainment of AVNRT from the ventricle but simultaneously during supraventricular tachycardia (SVT). They are activated in parallel during entrainment of AVRT but sequentially during SVT. The purpose of this study was to test the hypothesis that a DeltaHA (HA((entrainment)) - HA((SVT))) cutoff value of 0 reliably differentiates AVNRT from AVRT. Of 61 patients undergoing electrophysiologic evaluation for paroxysmal SVT, retrograde His-bundle potentials were recorded in 57 (93%) and entrainment performed in 49 (34 AVNRT, 15 AVRT). DeltaHA values during entrainment from the ventricle were significantly longer during AVNRT than AVRT (31 +/- 24 ms vs -38 +/- 31 ms, P <.001). All DeltaHA values were positive (minimum: 3 ms) for AVNRT and negative (maximum: -2 ms) for AVRT. DeltaHA of 0 had sensitivity, specificity. and positive predictive value of 100% for correct diagnosis. The DeltaHA criterion during entrainment of tachycardia from the ventricle reliably differentiates AVNRT (positive values) from AVRT (nega...Continue Reading

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Citations

Sep 7, 2012·Clinical Medicine Insights. Cardiology·Antoine Kossaify, Maya Zeeny
Nov 30, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, David L Fischman
Jul 20, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Gopi DandamudiJohn M Miller
Aug 25, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Miguel A AriasLuis Rodríguez-Padial
Aug 12, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T HoHoward H Weitz
Apr 8, 2010·Pacing and Clinical Electrophysiology : PACE·Krishnakumar NairKumaraswamy Nanthakumar
Oct 13, 2009·Journal of Cardiovascular Electrophysiology·Miguel A AriasLuis Rodríguez-Padial
Aug 7, 2009·Journal of Cardiovascular Electrophysiology·Miguel A AriasLuis Rodríguez-Padial
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
Jan 18, 2017·Pacing and Clinical Electrophysiology : PACE·Ryan T KippKurt S Hoffmayer
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
Aug 25, 2010·Circulation·Demosthenes G Katritsis, A John Camm
Aug 8, 2015·Advances in Health Sciences Education : Theory and Practice·Elizabeth Anne Kinsella, Susan Bidinosti
Apr 23, 2019·Journal of Arrhythmia·Ozcan OzekeDursun Aras
Apr 20, 2021·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Péter KupóRóbert Pap
Oct 5, 2021·Circulation. Arrhythmia and Electrophysiology·Mohan N ViswanathanMelvin M Scheinman

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