AI Article Synopsis
- The study investigates the relationship between early refractory premature ventricular complexes (ErPVCs) and the identification of an accessory pathway (AP) in patients with supraventricular tachycardia (SVT), specifically during atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT).
- The researchers hypothesized that ErPVCs would consistently show a significant time difference in the advancement of subsequent atrial activation during AVNRT to suggest the presence of an AP.
- Results from 65 patients revealed that 14 AVRT cases displayed an AP response with 100% specificity for predicting the presence of an accessory pathway, while none showed this
Article Abstract
Background: His-refractory premature ventricular complexes perturbing a supraventricular tachycardia (SVT) establish the presence of an accessory pathway (AP). Earlier premature ventricular complexes (ErPVCs) may perturb SVTs but are considered nondiagnostic.
Objective: The purpose of this study was to test the hypothesis that an ErPVC will always show a difference >35 ms in its advancement of the next atrial activation during atrioventricular nodal reentrant tachycardia (AVNRT). During atrioventricular reentrant tachycardia (AVRT), a PVC delivered close to the circuit can result in greater advancement of atrial activation due to retrograde conduction via an AP. Thus, an AP response, defined as ErPVC (HS) advancing the subsequent atrial activation (A-A) more than this minimum difference (AA ≤ HS+35 ms), establishes the presence of an AP.
Methods: Sixty-five consecutive patients with SVT were retrospectively evaluated. ErPVCs were defined when the ventricular pacing stimulus was >35 ms ahead of the His during tachycardia.
Results: Among the 65 cases, 43 were AVNRT and 22 AVRT. Fourteen AVRT cases had an AP response with a mean HS+35 ms of 336 ± 58 ms and AA of 309 ± 51ms. No AVNRT cases had an AP response. The specificity of an AP response to ErPVC in predicting AVRT was 100%.
Conclusion: An AP response to PVCs (AA ≤ HS+35 ms) is 100% specific for the presence of an AP.
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| http://dx.doi.org/10.1016/j.hrthm.2022.06.029 | DOI Listing |
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