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One of the maneuvers that help in the differential diagnosis of supraventricular tachycardias is the analysis of the response to transient entrainment or resetting of the tachycardia by right ventricular pacing. The basis of the analysis is the subtraction of the tachycardia cycle length (TCL) from the postpacing interval (PPI) measured at the pacing site, so called “PPI-TCL”, as first described for the differential diagnosis between AV nodal reentrant tachycardias (AVNRT) and tachycardias using a septal accessory pathways (AP) [1]. Further refinements of the maneuver included a correction for the rate-related increase in AV node delay (subtraction of the AH interval during tachycardia from the AH interval resulting from the last paced beat, the “corrected PPI-TCL”) [2], the use of single premature extrastimuli resulting in resetting [3] or a simplification of the maneuver by just subtracting the ventriculoatrial interval during tachycardia (VA interval) from stimulus to atrial interval during entrainment (SA interval), leading to the “SA-VA” value [1,4]. Shorter intervals of all these measurements are found in tachycardias mediated by AP as compared to AVNRT because the ventricles are part of the circuit in the former [1e4]. However, within AP mediated tachycardias, those using septal

indian pacing and electrophysiology journal

Unexpectedly short postpacing interval in a left free wall accessory pathway mediated tachycardia: A pitfall of the corrected postpacing interval algorithm?