Blog
About

0
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found

      Simplified Automated Right Ventricular Overdrive Pacing for Rapid Diagnosis of Supraventricular Tachycardia

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives: The purpose of this study was to prospectively evaluate the feasibility and diagnostic value of right ventricular overdrive pacing (RVOP) during supraventricular tachycardia (SVT) using a 2-catheter approach with automatic pacing from the right ventricular inflow (RVIT) and outflow tract (RVOT). Methods: One hundred and thirty-six consecutive patients (with 138 arrhythmias, mean age 36 ± 20 years, range 4-95) were enrolled in this study. Only coronary sinus and ablation catheters were used. RVOP was delivered from RVIT and then from RVOT. Each attempt consisted of 10 synchronized beats delivered at a cycle length of 10-40 ms longer than the tachycardia cycle length. Results: RVOP was sufficient to confirm the transition zone within the first 9 beats in the majority of SVTs. Atrial perturbation (acceleration, delayed) in the transition zone was detected in all patients with orthodromic atrioventricular (AV) reentry. Patients with typical AV nodal reentry, atypical AV nodal reentry and atrial tachycardia did not show atrial timing perturbation during fusion complexes of RVOP. Conclusions: Synchronized RVOP from RVIT or RVOT is an easy and accurate method for the quick and reliable differential diagnosis of SVT in various clinical settings, particularly when only a limited number of catheters are used.

          Related collections

          Most cited references 16

          • Record: found
          • Abstract: not found
          • Article: not found

          ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias).

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Occupational health hazards in the interventional laboratory: time for a safer environment.

            This document is a consensus statement by the major American societies of physicians who work in the interventional laboratory environment. It reviews available data on the prevalence of occupational health risks and summarizes ongoing epidemiologic studies designed to further elucidate these risks. Its purpose is to affirm that the interventional laboratory poses workplace hazards that must be acknowledged, better understood, and mitigated to the greatest extent possible. Vigorous efforts are advocated to reduce these hazards. Interventional physicians and their professional societies, working together with industry, should strive toward minimizing operator radiation exposure, eliminating the need for personal protective apparel, and ending the orthopedic and ergonomic consequences of the interventional laboratory work environment.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              First postpacing interval after tachycardia entrainment with correction for atrioventricular node delay: a simple maneuver for differential diagnosis of atrioventricular nodal reentrant tachycardias versus orthodromic reciprocating tachycardias.

              The difference between the first postpacing interval (PPI) after tachycardia entrainment from the right ventricular apex and the tachycardia cycle length (TCL) can be used as an index of proximity to the circuit. The purpose of this study was to determine whether the response to entrainment of tachycardia during ventricular stimulation with correction for AV node delay is a useful, simple maneuver for differentiating AV nodal reentrant tachycardia (AVNRT) from orthodromic reciprocating tachycardia (ORT) using a concealed accessory pathway. The study consisted of 193 consecutive patients who underwent electrophysiologic study and ablation of regular paroxysmal supraventricular tachycardia without preexcitation during sinus rhythm. Tachycardia entrainment was attempted through trains of 5 to 15 right ventricular apex pacing pulses. The increment in AV nodal conduction time in the first PPI was subtracted from the PPI-TCL difference (corrected PPI-TCL). Electrophysiologic study demonstrated ORT in 84 patients and AVNRT in 109 patients. Transient entrainment was achieved in all but 12 patients. The mean corrected PPI-TCL difference was significantly shorter in 77 patients with ORT (66 +/- 27 ms) than in 104 AVNRT patients (151 +/- 28 ms; P <.0001). Patients with septal accessory pathways had shorter corrected PPI-TCL differences than patients with free-wall accessory pathways. The presence of a corrected PPI-TCL difference <110 ms identified all but one patient with ORT, and no patients with AVNRT had such a difference. The return cycle after tachycardia entrainment by right ventricular apex stimulation with correction for AV node delay is a rapid, useful maneuver for differential diagnosis of AVNRT vs ORT in patients without preexcitation. The presence of a corrected PPI-TCL <110 ms accurately identified with high reliability those patients with ORT.
                Bookmark

                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2014
                September 2014
                10 September 2014
                : 129
                : 2
                : 93-102
                Affiliations
                aDepartment of Electroradiology, Institute of Nursing and Health Sciences, University of Rzeszow, Rzeszow, and bDepartment of Gastroenterology and Hepatology, Center for Postgraduate Medical Education, Warsaw, cELMedica, EP Network, Kielce, dDepartment of Cardiology and Pediatric Cardiology, Electrophysiology Division, Research and Development Center, Voivodeship Specialist Hospital, Wroclaw, and eDepartment of Pediatric Cardiology, SMU, Katowice, Poland; fDivision of Cardiovascular Medicine, EP Section, SUNY Downstate, Brooklyn, N.Y., USA
                Author notes
                *Adam S. Budzikowski, MD, PhD, FHRS, Division of Cardiovascular Medicine, EP Section, SUNY Downstate, 450 Clarkson Ave, Box 1199, Brooklyn, NY 11203 (USA), E-Mail abudzikowski@downstate.edu
                Article
                362786 Cardiology 2014;129:93-102
                10.1159/000362786
                25226811
                © 2014 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 4, Pages: 10
                Categories
                Original Research

                Comments

                Comment on this article