A technique for the rapid diagnosis of atrial tachycardia in the electrophysiology laboratory

Bradley P. Knight*, Adam Zivin, Joseph Souza, Matthew Flemming, Frank Pelosi, Rajiva Goyal, K. Ching Man, S. Adam Strickberger, Fred Morady

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

212 Scopus citations

Abstract

OBJECTIVE: The purpose of this study was to determine if the atrial response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction during paroxysmal supraventricular tachycardia is a useful diagnostic maneuver in the electrophysiology laboratory. BACKGROUND: Despite various maneuvers, it can be difficult to differentiate atrial tachycardia from other forms of paroxysmal supraventricular tachycardia. METHODS: The response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction was studied during four types of tachycardia: 1) atrioventricular nodal reentry (n = 102), 2) orthodromic reciprocating tachycardia (n = 43), 3) atrial tachycardia (n = 19) and 4) atrial tachycardia simulated by demand atrial pacing in patients with inducible atrioventricular nodal reentry or orthodromic reciprocating tachycardia (n = 32). The electrogram sequence upon cessation of ventricular pacing was, categorized as 'atrialventricular' (A-V) or 'atrial-atrial-ventricular' (A-A- V). RESULTS: The A-V response was observed in all cases of atrioventricular nodal reentrant and orthodromic reciprocating tachycardia. In contrast, the A-A-V response was observed in all cases of atrial tachycardia and simulated atrial tachycardia, even in the presence of dual atrioventricular nodal pathways or a concealed accessory atrioventricular pathway. CONCLUSIONS: In conclusion, an A-A-V response upon cessation of ventricular pacing associated with 1:1 ventriculoatrial conduction is highly sensitive and specific for the identification of atrial tachycardia in the electrophysiology laboratory.

Original languageEnglish (US)
Pages (from-to)775-781
Number of pages7
JournalJournal of the American College of Cardiology
Volume33
Issue number3
DOIs
StatePublished - Mar 1 1999

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'A technique for the rapid diagnosis of atrial tachycardia in the electrophysiology laboratory'. Together they form a unique fingerprint.

Cite this