Why the study?
Does simultaneous atrial and ventricular pacing help diagnose the mechanism of supraventricular tachycardia in cases of AVNRT with high degree AV block?
Does simultaneous atrial and ventricular pacing help diagnose the mechanism of supraventricular tachycardia in cases of AVNRT with high degree AV block?
Simultaneous atrial and ventricular pacing can be a useful maneuver to confirm the diagnosis of AVNRT in patients with high degree AV block where standard entrainment maneuvers fail.
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May aid AVNRT diagnosis when entrainment fails in high-degree block; leaves open validation in larger cohorts.
Pacing and entrainment maneuvers are essential for establishing the mechanism of supraventricular tachycardia (SVT), but may fail to do so if the SVT terminates or if pacing results in atrioventricular (AV) dissociation as opposed to entrainment of the arrhythmia. We present an unusual case of typical AV nodal reentrant tachycardia (AVNRT) with high degree AV block in which the diagnosis was confirmed using a novel maneuver consisting of simultaneous atrial and ventricular (A + V) pacing. The reproducible response to A + V pacing at varying cycle lengths established the diagnosis of AVNRT in this case.
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Bhattacharya et al. (2010) studied this question.
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