Key result
The presence of a pseudo R' wave in lead aVR was significantly more common in patients with AVNRT (61.0%) than in those with AVRT (14.3%), offering 61% sensitivity and 85.7% specificity.
Why the study?
The study was conducted to evaluate the diagnostic efficacy of traditional and newly proposed ECG criteria in identifying AVNRT and AVRT.
Do traditional and novel ECG criteria accurately differentiate AVNRT from AVRT in patients with SVT?
Observational (n=62)
No
Do traditional and novel ECG criteria accurately differentiate AVNRT from AVRT in patients with SVT?
Absolute Event Rate: 61% vs 14.3%
p-value: p=<0.001
Integrating traditional and novel ECG criteria, particularly lead aVR analysis, enhances the non-invasive differentiation of AVNRT and AVRT prior to electrophysiology study.
May aid non-invasive AVNRT/AVRT differentiation; leaves open prospective validation before practice change.
The two most frequent causes of paroxysmal SVT are atrioventricular tachycardia (AVRT) and atrioventricular nodal re-entrant tachycardia (AVNRT). The purpose of this study was to assess the diagnostic efficacy of traditional and newly proposed ECG criteria in the identification of Avnrt and Avrt. Aim of the Study: The aim of this study was to evaluate Atrioventricular Nodal Reentrant Tachycardia (AVNRT) and Atrioventricular Re-entrant Tachycardia (AVRT) using both traditional and novel criteria. Methods: This prospective observational study was conducted at the Electrophysiology Unit, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD) in Dhaka, from February 2019 to January 2020. A total of 62 patients with Supraventricular Tachycardia (SVT) undergoing electrophysiology study (EPS) were included. Standard ECG criteria were applied for the differential diagnosis, and electrophysiological diagnoses were made using established criteria. Statistical analysis, including descriptive statistics and appropriate tests, was performed using SPSS 23.0. Result: In our study of 62 patients with Supraventricular Tachycardia (SVT), we found that 66.1% had AVNRT and 33.9% had AVRT. The mean age in AVNRT was higher than AVRT (41.3 ± 9.7 vs. 38.5 ± 14.3, p = 0.36) with statistically no significant difference, with similar gender distribution between AVNRT and AVRT groups. Classical AVNRT criteria were present in 30.6% of patients, and 45.2% showed a Pseudo R' wave in aVR. Additionally, 30.6% had an RP interval ≥100ms, more prevalent in AVRT patients (66.7%). Conclusion: Integrating traditional and novel criteria, including lead aVR analysis, enhances the electrocardiographic diagnosis of AVNRT and AVRT, offering a pathway to refined patient care.
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Hamid et al. (2024) conducted an observational in Supraventricular Tachycardia (SVT) (n=62). ECG criteria (including pseudo R' wave in aVR) vs. Electrophysiology study (gold standard) was evaluated on Presence of pseudo R' wave in aVR (p=<0.001). The presence of a pseudo R' wave in lead aVR was significantly more common in patients with AVNRT (61.0%) than in those with AVRT (14.3%), offering 61% sensitivity and 85.7% specificity.
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