November 29, 2005Journal of Cardiovascular Electrophysiology
Reanalysis of The “Pseudo A‐A‐V” Response to Ventricular Entrainment of Supraventricular Tachycardia: Importance of His‐Bundle Timing
Key result
Incorporating His-bundle timing into the electrogram response following ventricular pacing correctly identified AVNRT as an A-H response in 100% of patients with long HV intervals.
Why the study?
Does incorporating His-bundle timing in the electrogram response following ventricular pacing improve the identification of tachycardia mechanisms in patients with AVNRT and long HV intervals?
Population
8 patients (7 men) with AVNRT, underlying bundle branch block, and long HV (>55 msec) intervals
Comparison
Inclusion of His-bundle timing in the… vs Conventional classification of electrogram…
Design
Case_series
Authors
Discussion
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Implication
May aid AVNRT diagnosis in long-HV cases during EP study; leaves open prospective validation before wider adoption.
Study Design
Type
Observational (n=8)
Structured PICO
Does incorporating His-bundle timing in the electrogram response following ventricular pacing improve the identification of tachycardia mechanisms in patients with AVNRT and long HV intervals?
P
Population
8 patients (7 men) with AVNRT, underlying bundle branch block, and long HV (>55 msec) intervals
I
Intervention
Inclusion of His-bundle timing in the electrogram response (ER) following ventricular pacing at 10-40 msec shorter than the tachycardia cycle length during SVT (classifying as A-A-H or A-H)
C
Comparator
Conventional classification of electrogram response (A-A-V or A-V)
O
Outcome
Electrogram response classification to identify tachycardia mechanismsurrogate
Main Result
Absolute Event Rate: 100% vs 62.5%
Incorporating His-bundle timing into the electrogram response following ventricular pacing eliminates the pseudo A-A-V response in patients with AVNRT and long HV intervals, improving diagnostic accuracy.
Cite This Study
Vijayaraman et al. (2005) conducted an observational in Atrioventricular nodal reentrant tachycardia (AVNRT) with long HV intervals (n=8). Inclusion of His-bundle timing in electrogram response (A-H or A-A-H classification) vs. Conventional classification (A-V or A-A-V) was evaluated on Electrogram response classification. Incorporating His-bundle timing into the electrogram response following ventricular pacing correctly identified AVNRT as an A-H response in 100% of patients with long HV intervals.