Differential entrainment distinguishes atrioventricular nodal reentry tachycardia from atrioventricular reentrant tachycardia.
ABSTRACT Entrainment from the right ventricular (RV) apex and the base has been used to distinguish atrioventricular reentrant tachycardia (AVRT) from atrioventricular nodal reentry tachycardia (AVNRT). The difference in the entrainment response from the RV apex in comparison with the RV base has not been tested.
Fifty-nine consecutive patients referred for ablation of supraventricular tachycardia (SVT) were included. Entrainment of SVT was performed from the RV apex and base, pacing at 10-40-ms faster than the tachycardia cycle length. SA interval was calculated from stimulus to earliest atrial electrogram. Ventricle to atrium (VA) interval was measured from the RV electrogram (apex and base) to the earliest atrial electrogram during tachycardia. The SA-VA interval from apex and base was measured and the difference between them was calculated.
Thirty-six AVNRT and 23 AVRT patients were enrolled. Mean age was 44 ± 12 years; 52% were male. The [SA-VA]apex-[SA-VA]base was demonstrable in 84.7% of patients and measured -9.4 ± 6.6 in AVNRT and 10 ± 11.3 in AVRT, P < 0.001. The difference was negative for all AVNRT cases and positive for all septal accessory pathways (APs).
The difference between entrainment from the apex and base is readily performed and is diagnostic for all AVNRTs and septal APs.
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ABSTRACT: Atrioventricular nodal re-entry tachycardia is a common supraventricular arrhythmia. The rate of recurrence is relatively high, and accordingly ablative therapy became the first-line suggested therapy. In this review, we highlight the electrocardiographic clues to the diagnosis of atrioventricular nodal re-entry tachycardia, also we present the electrophysiological data and maneuvers that enable the ruling out of other supraventricular tachycardias and ensure an accurate and specific diagnosis of atrioventricular nodal reentrant tachycardia.Clinical Medicine Insights. Cardiology. 01/2012; 6:111-7.
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ABSTRACT: This paper is the second part of a review of the phenomena of resetting and entrainment of reentrant arrhythmias. It describes the practical and clinical uses of resetting and entrainment, including the results of a variety of studies for these purposes. Given the amount of information generated, it is out of the scope of this review to comment in detail about each of the published studies. We rather present the basis for each described clinical use and for each type of arrhythmia in which these phenomena have been used with illustrative examples. The review covers: resetting response patterns; resetting/entrainment and termination; resetting/entrainment, fusion, and reentry; analysis of the postpacing interval; concealed entrainment; resetting/entrainment as an aid in the differential diagnosis among different arrhythmic mechanisms; usefulness of these phenomena in arrhythmic mechanisms other than macrorreentry. Finally, we make some comments about the recent use of these phenomena and propose two new criteria for entrainment recognition.Pacing and Clinical Electrophysiology 01/2013; · 1.75 Impact Factor