| Title: |
Characterizing Dual Atrioventricular Nodal Physiology in Pediatric Patients with Atrioventricular Nodal Reentrant Tachycardia. |
| Authors: |
BLURTON, DOMINIC J., DUBIN, ANNE M., CHIESA, NANCY A., VAN HARE, GEORGE F., COLLINS, KATHRYN K. |
| Source: |
Journal of Cardiovascular Electrophysiology; Jun2006, Vol. 17 Issue 6, p638-644, 7p, 2 Charts, 6 Graphs |
| Subject Terms: |
TACHYCARDIA, ARRHYTHMIA, ATRIOVENTRICULAR node, ATRIAL flutter, VENTRICULAR tachycardia, PALPITATION |
| Abstract: |
Introduction: Dual atrioventricular (AV) nodal physiology, defined as an AH jump ≥50 msec with a 10 msec decrease in A1A2, is the substrate for atrioventricular nodal reentrant tachycardia (AVNRT) and yet it is present in a minority of pediatric patients with AVNRT. Our objective was to characterize dual AV nodal physiology as it pertains to a pediatric population. Methods/Results: We retrospectively reviewed invasive electrophysiology studies in 92 patients with AVNRT (age12.1 ± 3.7 yrs) and in 46 controls without AVNRT (age 13.3 ± 3.7 yrs). Diagnoses in controls: syncope (N = 31), palpitations (N = 6), atrial flutter (N = 3), history of atrial tachycardia with no inducible arrhythmia (N = 3), and ventricular tachycardia (N = 3). General anesthesia was used in 49% of AVNRT and 52% of controls, P = 0.86. There were no differences in PR, AH, HV, or AV block cycle length. With A1A2 atrial stimulation, AVNRT patients had a significantly longer maximum AH achieved (324 ± 104 msec vs 255 ± 67 msec, P = 0.001), and a shorter AVNERP (276 ± 49 msec vs 313 ± 68 msec P = 0.0005). An AH jump ≥50 msec was found in 42% of AVNRT versus 30% of controls (P = 0.2). Using a ROC graph we found that an AH jump of any size is a poor predictor of AVNRT. With atrial overdrive pacing, PR ≥ RR was seen more commonly in AVNRT versus controls, (55/91(60%) vs 6/46 (13%) P = 0.000). Conclusions: Neither the common definition of dual AV nodes or redefining an AH jump as some value <50 msec are reliable methods to define dual AV nodes or to predict AVNRT in pediatric patients. PR ≥ RR is a relatively good predictor of AVNRT. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Cardiovascular Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
|
Full text is not displayed to guests. |
Login for full access.
|
