Key result
Clinical and ECG features diagnose ~95% of AVNRT cases using pounding neck and pseudo r'/s waves.
Why the study?
AVNRT and AVRT are the most common forms of paroxysmal regular supraventricular tachycardias, motivating evaluation of their clinical, ECG, and electrophysiological findings.
Do specific clinical symptoms and ECG features accurately differentiate AVNRT from AVRT in patients with narrow QRS tachycardia?
Observational (n=121)
Do specific clinical symptoms and ECG features accurately differentiate AVNRT from AVRT in patients with narrow QRS tachycardia?
Absolute Event Rate: 94.7% vs 87%
Specific clinical symptoms (pounding neck, presyncope) and ECG features (pseudo r'/s waves, identifiable P waves) can accurately differentiate AVNRT from AVRT in patients with narrow QRS tachycardia.
Supports cautious use of clinical-ECG criteria in narrow QRS tachycardia; leaves open need for confirmatory trials.
Aim: Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) are the most common forms of paroxysmal regular supraventricular tachycardias. Materials & methods: The clinical, ECG and electrophysiological findings of 121 patients with narrow QRS tachycardia were evaluated prospectively. Results: A total of 75 (62%) of the patients had AVNRT while 46 (38%) had AVRT. Pounding sensation in the neck (40 vs 15.2%; p = 0.004), presynope (26.7 vs 56.5%; p = 0.001) identifiable P wave after QRS complex (25.3 vs 73.9%; p = 0.001), pseudo r′/s waves (45.3 vs 4.3%; p = 0.001), limb leads ST-T changes (34.7 vs 60.9%; p = 0.004) were the significant changes observed. A total of 94.7% of AVNRT and 87% of AVRT could be diagnosed correctly considering both clinical and ECG criteria. Conclusion: Pounding sensation in the neck and presyncope along with ECG features like identifiable P wave after QRS complex, pseudo r′/s waves and limb lead ST-T changes very accurately differentiate AVNRT and AVRT.
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Poptani et al. (2020) conducted an observational in Narrow QRS tachycardia (n=121). AVNRT vs. AVRT was evaluated on Correct diagnosis using clinical and ECG criteria. Clinical and ECG evaluation correctly diagnosed 94.7% of AVNRT and 87% of AVRT cases, with specific features like pounding neck sensation and pseudo r'/s waves accurately differentiating them.
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