Evaluating the timing of premature atrial complexes and proximal coronary sinus recordings helps differentiate between atrioventricular nodal re-entry tachycardia variants and AP-mediated tachycardias.
A wide complex tachycardia may result from supraventricular tachycardia (SVT) with bundle branch block (pre-existing or tachycardia-related), SVT with atrioventricular conduction over an accessory pathway (AP), or ventricular tachycardia (VT). The timing of PACs and their effect on tachycardia can help differentiate between atrioventricular nodal re-entry tachycardia variants and AP-mediated tachycardias. A proximal coronary sinus recording is critical for evaluating septal refractoriness and excluding nodal tachycardia and other forms of nodal bystander pre-excitation (such as nodoventricular or nodofascicular re-entrant tachycardia).
Korkmaz et al. (2026) conducted a review in Wide QRS Complex Tachycardia. Premature Atrial Complexes (PACs) was evaluated. Evaluating the timing of premature atrial complexes and proximal coronary sinus recordings helps differentiate between atrioventricular nodal re-entry tachycardia variants and AP-mediated tachycardias.