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Noninvasive Diagnosis in Patients with Undocumented Tachycardias:
Author(s) -
TEBBENJOHANNS JÜRGEN,
NIEHAUS MICHAEL,
KORTE THOMAS,
DREXLER HELMUT
Publication year - 1999
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1999.tb01262.x
Subject(s) - medicine , cardiology , intensive care medicine
Noninvasive Diagnosis in Patients with Undocumented Tachycardias.Introduction: Patients with symptoms suggestive of paroxysmal supraventricular tachycardia (PSVT) but no tachycardia documentation often undergo diagnostic electrophysiologic study. In dual AV node physiology with AV node reentrant tachycardia (AVNRT), the anterograde fast pathway is more sensitive than the slow pathway to the effects of adenosine. The purpose of the study was to test the hypothesis that adenosine can be used as a bedside test for the diagnosis of dual AV node physiology and hence for AVNRT. Methods and Results: During electrophysiologic study, 37 patients without prior documentation hut symptoms indicative for PSVT received incremental dosages of adenosine during sinus rhythm until second‐degree or greater AV block was observed. Suggestive signs of dual AV node physiology on the surface ECG (sudden jump of PQ interval ≥ 50 msec) were found in 13 (76%) of 17 patients with inducible AVNRT but in only 1 (5%) of the remaining patients (P < 0.01). In the AVNRT group, the maximal increase of the PQ interval between two beats was greater (88 ± 45 msec) than in the remaining 20 patients (17 ± 11 msec) (P < 0.01). Conclusion: Careful evaluation of surface ECG during administration of adenosine helps to identify patients prone to AVNRT. The adenosine test is a valuable noninvasive adjunct in patients with undocumented palpitations suggestive of PSVT