July 7, 1998Circulation
Noninvasive Diagnosis of Dual AV Node Physiology in Patients With AV Nodal Reentrant Tachycardia by Administration of Adenosine-5′-Triphosphate During Sinus Rhythm
Key result
Administration of ATP during sinus rhythm elicited signs of dual AV node physiology in 76% of patients with AVNRT compared to 5% of controls (P<0.001).
Why the study?
Does intravenous administration of ATP during sinus rhythm identify dual AV nodal pathways in patients with AVNRT?
Population
n=63 patients undergoing electrophysiological study, comprising 42 patients with spontaneous and inducible…
Comparison
Intravenous administration of incremental doses… vs Control group of patients with no evidence of…
Design
Cross-sectional
Authors
Discussion
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Implication
May support bedside ATP testing to identify dual AV nodal pathways; leaves open prospective validation before clinical adoption.
Study Design
Type
Case-Control (n=63)
Structured PICO
Does intravenous administration of ATP during sinus rhythm identify dual AV nodal pathways in patients with AVNRT?
P
Population
63 patients undergoing electrophysiological study, comprising 42 with spontaneous and inducible sustained AVNRT and 21 controls without dual AV nodal physiology.
E
Exposure
Intravenous administration of incremental doses of adenosine-5'-triphosphate (ATP) (from 10 to 50 mg) during sinus rhythm
C
Comparator
Control group of patients with no evidence of dual AV nodal physiology or inducible AVNRT
O
Outcome
Signs suggestive of dual AV node physiology after ATP administration ('jump' of AH ≥50 ms between 2 consecutive beats, ≥1 AV nodal echo beat, or initiation of AVNRT)surrogate
Main Result
Absolute Event Rate: 76% vs 5%
p-value: p=<0.001
Administration of ATP during sinus rhythm is a useful noninvasive bedside test for identifying patients with dual AV nodal pathways who are prone to AVNRT.
Cite This Study
Belhassen et al. (1998) conducted a case-control in Atrioventricular nodal reentry tachycardia (AVNRT) (n=63). Administration of adenosine-5'-triphosphate (ATP) during sinus rhythm vs. Patients without AV nodal duality (control group) was evaluated on Signs suggestive of dual AV node physiology after ATP administration during sinus rhythm (p=<0.001). Administration of ATP during sinus rhythm elicited signs of dual AV node physiology in 76% of patients with AVNRT compared to 5% of controls (P<0.001).