Ventriculoatrial intervals: Diagnostic use in paroxysmal supraventricular tachycardia

D. G. Benditt, E. L.C. Pritchett, W. M. Smith, J. J. Gallagher

Research output: Contribution to journalArticlepeer-review

104 Scopus citations

Abstract

Reciprocating tachycardia due to reentry either within the atrioventricular (AV) node or using an accessory AV pathway are a common cause of paroxysmal supraventricular tachycardia in humans. Unfortunately, although of potential therapeutic value, differentiation of these forms of reciprocating tachycardia may be difficult and require detailed electrophysiologic study. To develop diagnostic criteria that permit exclusion of participation of an accessory AV pathway in reciprocating tachycardia without extensive laboratory testing, results of electrophysiologic studies were examined in 50 patients with Wolff-Parkinson-White syndrome, 15 patients with accessory AV pathways that conducted only in the ventriculoatrial direction, and 15 patients with reentry within the AV node. The interval between onset of ventricular activation and both earliest recorded atrial activity (V-Amin) and high lateral right atrial electrogram (V-HRA) was measured during tachycardia. A V-Amin of 61 ms or less or V-HRA of 95 ms or less did not occur in patients with accessory AV pathways, but occurred frequently (12 of 15 and 7 of 8, respectively) in patients with reentry within the AV node. Therefore, in patients with paroxysmal reciprocating tachycardias, V-A interval measurements provide a screening test capable of excluding participation of an accessory AV pathway.

Original languageEnglish (US)
Pages (from-to)161-166
Number of pages6
JournalAnnals of internal medicine
Volume91
Issue number2
DOIs
StatePublished - Jan 1 1979

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