Key result
Applying 6 versus 8 stimuli in basic cycle length yielded no difference in the measured anterograde and retrograde effective refractory period of the atrioventricular node.
Why the study?
Refractory periods depend on prior cycle length and are typically measured after 8 to 10 paced beats, but whether fewer stimuli suffice for steady-state measurement remains to be evaluated.
Does using 6 stimuli instead of 8 stimuli in basic cycle length affect the measurement of effective refractory period of the AV node during electrophysiologic study?
Does using 6 stimuli instead of 8 stimuli in basic cycle length affect the measurement of effective refractory period of the AV node during electrophysiologic study?
Answers are grounded in this paper and cite their sources.
Using 6 stimuli in basic cycle length is comparable to the standard 8 stimuli for reaching steady state in effective refractory period measurement of the AV node, potentially shortening procedure time.
Background: Refractory periods are measured by the extrastimulus technique, whereby a single extrastimulus is introduced at progressively shorter coupling intervals until a response is no longer elicited. Purpose: As refractoriness of cardiac tissues depends on prior cycle length, refractory periods should be determined at a fixed cycle length within the physiologic range. The extrastimulus is delivered after a train of 8 to 10 paced complexes to allow time for reasonable stabilization of refractoriness, which is usually accomplished after the first 3 or 4 paced beats. Objectives: We conducted this study to compare the effect of 6 vs 8 stimuli in basic cycle length (BCL) in measurement of effective refractory period (ERP). Materials and Methods: During electrophysiologic study (EPS) of 100 consecutive patients, anterograde and retrograde ERP of atrioventricular node (AVN) were measured by introduction of 6 vs 8 stimuli in BCL and premature beat, then the results were compared. Results: Recorded anterograde and retrograde ERP of AVN applying 6 vs 8 stimuli in BCL were compared and no difference was detected. Conclusion: We concluded that for ERP measurement of AVN, 6 stimuli in BCL is comparable to 8 stimuli in reaching the steady state.
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Sadr-Ameli et al. (2021) studied Patients undergoing electrophysiologic study (n=100). 6 stimuli in basic cycle length (BCL) vs. 8 stimuli in basic cycle length (BCL) was evaluated on Anterograde and retrograde effective refractory period (ERP) of the atrioventricular node (AVN). Applying 6 versus 8 stimuli in basic cycle length yielded no difference in the measured anterograde and retrograde effective refractory period of the atrioventricular node.
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