Analyses of the Mode of Termination During Diagnostic Ventricular Pacing to Differentiate the Mechanisms of Supraventricular Tachycardias.
JACC Clin Electrophysiol
; 3(11): 1252-1261, 2017 11.
Article
em En
| MEDLINE
| ID: mdl-29759621
ABSTRACT
OBJECTIVES:
The goal of this study was to determine the diagnostic yield of analyzing the mode of termination during ventricular overdrive pacing (VOP) to differentiate the mechanisms of supraventricular tachycardias (SVTs).BACKGROUND:
The majority of the diagnostic criteria for VOP rely on successful entrainment, but termination of SVTs is common during VOP.METHODS:
We studied 225 SVTs with a 11 atrioventricular relationship, including 34 atrial tachycardias, 67 orthodromic reciprocating tachycardias (ORTs) (including 4 ORTs using accessory pathways [APs] with decremental properties), and 124 atrioventricular nodal re-entrant tachycardias. The total pacing prematurity (TPP) needed to reset or terminate the SVT was calculated by using a simplified method, and the post-pacing interval minus the tachycardia cycle length (PPI - TCL) was predicted from the TPP.RESULTS:
VOP terminated 87 SVTs (39%). No atrial tachycardias were terminated by VOP in this study. SVT termination occurred after (n = 71) or before (n = 16) atrial resetting. The predicted PPI - TCL was highly correlated with the measured PPI - TCL (r = 0.96; p < 0.001). The TPP had diagnostic accuracy equivalent to the predicted PPI - TCL. The TPP was measurable irrespective of the termination mode and correctly diagnosed ORTs with decremental APs. All ORTs using septal APs and no atrioventricular nodal re-entrant tachycardias had a TPP <125 ms. Considering other criteria evaluable in terminated SVTs, a combined criteria of a TPP <125 ms and atrial capture/termination within the fusion period were specific for ORTs using free-wall APs, except for left anterolateral/lateral sites.CONCLUSIONS:
The termination analyses were useful for differential diagnoses of SVTs terminated during VOP.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Taquicardia Supraventricular
/
Técnicas Eletrofisiológicas Cardíacas
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Terapia de Ressincronização Cardíaca
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Ventrículos do Coração
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
JACC Clin Electrophysiol
Ano de publicação:
2017
Tipo de documento:
Article