Arrhythmias & electrophysiologyDiagnostic or prognostic study
Detailed analysis of tachycardia cycle length aids diagnosis of the mechanism and location of atrial tachycardias
- Retrospective diagnostic study
Authors' conclusion
Detailed analysis of the tachycardia CL helps predict the AT-mechanism and the active AT chamber before an initial mapping.
Study context
- Population
- Atrial tachycardias with activation mapsAtrial tachycardia (AT) maps in 95 patients
- Participants
- 138 participants
- Comparison
- Tachycardia cycle length (CL) features for predicting AT mechanism and chamber
- focal-ATsn = 8reference
- macroreentrant-ATsn = 94
- localized-ATsn = 36
Performance
As reported in the abstract
Maximal CL (MCL) and minimal CL (mCL)
| Test or model | Maximal CL (MCL) | Minimal CL (mCL) |
|---|---|---|
| focal-ATs | 506 (421-555) | 427 (347-508) |
| macroreentrant-ATs | 288 (253-348) | 283 (243-341) |
| localized-ATs | 314 (261-349) | 295 (248-340) |
- macroreentrant-ATs vs focal-ATs: P = 0.0001 — MCL
- macroreentrant-ATs vs focal-ATs: P = 0.0012 — mCL
- localized-ATs vs focal-ATs: P = 0.0016 — MCL
- localized-ATs vs focal-ATs: P = 0.0047 — mCL
Further findings
Absolute CL-variation (MCL-mCL) < 24 ms for re-entrant vs focal ATs
- Sensitivity
- 96.9%
- Specificity
- 100%
- PPV
- 100%
- NPV
- 66.7%
Beat-by-beat CL-alternation
- Observed, all re-entrant
- 10/138 (7.2%)
- PPV for re-entrant mechanism
- 100%
CL-respiration correlation
- Observed in ATs
- 28/138 (20.3%)
- RA-ATs
- 24/41, 85.7%
- LA-ATs
- 4/97, 4.1%
- Positive correlation PPV for RA-ATs
- 85.7%
- Negative correlation NPV for LA-ATs
- 84.5%
Original publication
Detailed analysis of tachycardia cycle length aids diagnosis of the mechanism and location of atrial tachycardias. Europace. Published 10 July 2023. doi:10.1093/europace/euad195
Summarised from the published abstract; every number is checked against it