Key result
Standard 12-lead electrocardiogram analysis revealed that atrioventricular nodal reentry tachycardia (short RP-long PR) was the most common mechanism, accounting for 89.4% of regular narrow-QRS complex tachycardia cases.
Why the study?
Differentiating between SVT types using ECG criteria is clinically important to predict underlying mechanisms and guide acute termination and ablation therapies.
Does standard 12-lead ECG differentiate types of regular narrow-QRS complex tachycardia in emergency room patients?
Cross-Sectional (n=85)
No
Does standard 12-lead ECG differentiate types of regular narrow-QRS complex tachycardia in emergency room patients?
Standard 12-lead ECG criteria, specifically RP-PR intervals and pseudo r/s waves, are useful for differentiating types of regular narrow-QRS complex tachycardia, with AVNRT being the most common type.
Answers are grounded in this paper and cite their sources.
May inform ECG differentiation of narrow-QRS tachycardia in ER settings; leaves open prospective validation of criteria.
Background Supraventricular tachycardia comprises 80% of regular tachycardia that present to the emergency rooms and cardiology clinics. It is of many mechanisms and electrocardiography features. In a high percentage of cases, it occurs in the structurally-normal heart. Epidemiologically it has been discovered that it is more widespread in females than in males. Objectives Electrocardiography (ECG) criteria help differentiate the types of Supraventricular tachycardia (SVT) and predict the underlying mechanism. For example, the patient with short R.P. and long P.R. types is more suggestive of atrioventricular nodal reentrant tachycardia (AVNRT), where ablation therapy is more successful than in atrial tachycardia and atrioventricular reentrant tachycardia (AVRT) Differentiating between AVNRT, AVRT, and atrial tachycardia is extremely significant regarding the acute termination by medications; Adenosine and Calcium-channel blockers (CCBs) are found more effective in atrioventricular reentrant tachycardia, CCBs should be avoided in long R.P. and short P.R. Patients and Methods A retrospective cross-sectional study was conducted between December 2016 and February 2018. This study included patients who visited the emergency room with a narrow-QRS-complex tachycardia. Results Eighty-five patients with regular narrow-QRS-complex tachycardia were included. The mean ± S.D. of the participants-age was 46.29 years ±12.71, 56 cases (65.9%) were females, and 29 (34.1%) were males. The mean ± S.D. of the disease duration of the condition was 5.07±5.52 years, and a frequency of 3.8 attacks per 6 months, and a mean duration of each episode was approximately 80 minutes for each episode. Regarding the symptomatology of tachycardia, almost all patients had symptoms of palpitation, 11.8% had presyncope, and 4.7% had syncope. Conclusion Atrioventricular nodal reentries tachycardia (slow/fast) are the most common in our study. AVRNT was found more prevalent in females than males. Atrioventricular reentry tachycardia was found in males more than females in our study.
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Shaikhani et al. (2021) conducted a cross-sectional in Regular narrow-QRS-complex tachycardia (n=85). Standard 12-lead electrocardiogram was evaluated on Prevalence of short RP-long PR interval (suggestive of AVNRT). Standard 12-lead electrocardiogram analysis revealed that atrioventricular nodal reentry tachycardia (short RP-long PR) was the most common mechanism, accounting for 89.4% of regular narrow-QRS complex tachycardia cases.
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