Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias.
Pacing Clin Electrophysiol
; 47(3): 383-391, 2024 03.
Article
em En
| MEDLINE
| ID: mdl-38348921
ABSTRACT
OBJECTIVE:
The presence of cannon A waves, the so called "frog sign", has traditionally been considered diagnostic of atrioventricular nodal re-entrant tachycardia (AVNRT). Nevertheless, it has never been systematically evaluated. The aim of this study is to assess the independent diagnostic utility of cannon A waves in the differential diagnosis of supraventricular tachycardias (SVTs).METHODS:
We prospectively included 100 patients who underwent an electrophysiology (EP) study for SVT. The right jugular venous pulse was recorded during the study. In 61 patients, invasive central venous pressure (CVP) was registered as well. CVP increase is thought to be related with the timing between atria and ventricle depolarization; two groups were prespecified, the short VA interval tachycardias (including typical AVNRT and atrioventricular reciprocating tachycardia (AVRT) mediated by a septal accessory pathway) and the long VA interval tachycardias (including atypical AVNRT and AVRT mediated by a left free wall accessory pathway).RESULTS:
The relationship between cannon A waves and AVNRT did not reach the statistical significance (OR 3.01; p = .058); On the other hand, it was clearly associated with the final diagnosis of a short VA interval tachycardia (OR 10.21; p < .001). CVP increase showed an inversely proportional relationship with the VA interval during tachycardia (b = -.020; p < .001). CVP increase was larger in cases of AVNRT (4.0 mmHg vs. 1.2 mmHg; p < .001) and short VA interval tachycardias (3.9 mmHg vs. 1.2 mmHg; p < .001).CONCLUSION:
The presence of cannon A waves is associated with the final diagnosis of short VA interval tachycardias.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Taquicardia Paroxística
/
Taquicardia por Reentrada no Nó Atrioventricular
/
Taquicardia Supraventricular
/
Taquicardia Ventricular
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Espanha