Key result
RVA entrainment yields a shorter ~9 ms PPI-TCL difference in BBR-VT versus MR-VT and AVNRT.
Why the study?
Does the postpacing interval minus tachycardia cycle length (PPI-TCL) after entrainment by right ventricular apex stimulation differentiate bundle-branch reentry ventricular tachycardia from other tachycardias?
Observational (n=127)
Does the postpacing interval minus tachycardia cycle length (PPI-TCL) after entrainment by right ventricular apex stimulation differentiate bundle-branch reentry ventricular tachycardia from other tachycardias?
Effect estimate: 9+/-11 ms (BBR-VT) vs 109+/-48 ms (MR-VT) and 150+/-29 ms (AVNRT)
p-value: p=<0.0001
A PPI-TCL difference of <30 ms after entrainment by right ventricular apex stimulation is highly suggestive of bundle-branch reentry ventricular tachycardia, whereas a difference >30 ms makes it unlikely.
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PPI-TCL <30 ms after RV apex entrainment may suggest BBR-VT; leaves open prospective validation before routine use.
Merino et al. (2001) conducted an observational in Bundle-branch reentry ventricular tachycardia (n=127). Transient entrainment by right ventricular apex pacing vs. Myocardial reentrant VT and AV nodal reentrant tachycardia was evaluated on Postpacing interval minus tachycardia cycle length (PPI-TCL) difference (9+/-11 ms (BBR-VT) vs 109+/-48 ms (MR-VT) and 150+/-29 ms (AVNRT), p=<0.0001). Transient entrainment by right ventricular apex pacing yielded a significantly shorter mean PPI-TCL difference in BBR-VT (9±11 ms) than in MR-VT (109±48 ms) and AVNRT (150±29 ms) (P<0.0001).
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