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ȣ - 530283 258 |
Usefulness of Difference between Stimulus-atrial Interval and Ventriculo-atrial Interval during Tachycardia in Differentiating Atrioventricular Nodal Reentrant Tachycardia from Orthodromic Reciprocating Tachycardia |
계명대학교 동산의료원 심장내과¹ , 대구 카톨릭 대학병원 심장내과², 계명대학교 의과대학 의료정보학 교실³ |
박형섭¹, 김윤년¹ , 최현철¹, 강선영¹, 조윤경¹, 윤혁준¹, 김형섭¹, 남창욱¹, 허승호¹, 김권배¹, 김종래², 이영수², 김기식², 박희준³ |
Background: There have been numerous parameters for differentiating atroventricular nodal reentrant tachycardia (AVNRT) from orthodromic reciprocating tachycardia (ORT) using a concealed bypass tract. The aim of this study was to evaluate the discriminating value of these parameters. Methods: This study included 106 consecutive patients who underwent radiofrequency catheter ablation for paroxysmal supraventricular tachycardia without pre-excitation at two medical centers. The right ventriclular apex was paced at a cycle length 20 to 40 ms shorter than the tachycardia cycle length (TCL). The ventriculo-atrial (VA) interval and TCL were measured just before pacing. The first post-pacing interval (PPI) and stimulus-atrial (SA) interval were also measured on cessation of ventricular pacing. Results: Between 69 patients with AVNRT and 37 patients with ORT, there were significant differences in mean values for VA interval, SA interval, SA-VA difference, PPI-TCL difference, and corrected PPI-TCL difference. Receiver operating characteristic (ROC) curves showed that the area under ROC curve for SA-VA difference was largest in differentiating AVNRT from ORT (0.817, p<0.001). The cutoff value of 85 msec for VA interval provided best discriminative value with a sensitivity of 81.2% and specificity of 62.2% in differentiating AVNRT from ORT. Conclusion: The SA-VA difference could be more useful parameters for differentiating AVNRT from ORT.
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AVNRT (n=69) |
ORT (n=37) |
P value |
SA-VA difference |
118.0 ± 45.6 |
68.7 ± 33.7 |
<0.001 |
SA interval |
177.9 ± 57.2 |
221.7 ± 43.2 |
<0.001 |
VA interval |
59.9 ± 40.4 |
153.0 ± 30.6 |
<0.001 |
PPI-TCL difference |
152.5 ± 60.5 |
113.7 ± 57.2 |
0.002 |
Corrected PPI-TCL difference |
115.1 ± 53.5 |
82.6 ± 35.0 |
<0.001 |
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