Arrhythmias & electrophysiology
The Value of Programmed Ventricular Extrastimuli From the Right Ventricular Basal Septum During Supraventricular Tachycardia
Authors' conclusion
The ΔSA-VAbase during programmed ventricular extrastimuli produced a robust differentiation between AVNRT and AVRT regardless of the AP location with ≧85 milliseconds as an excellent cutoff point. This straightforward technique further allowed localizing 4 general AP sites.
Study context
- Population
- Patients with supraventricular tachycardia (SVT) (AVNRT or atrioventricular reciprocating tachycardia (AVRT)) undergoing programmed ventricular extrastimuli from both right ventricular (RV) basal septum and RV apex
- Participants
- 105 vs 130
- Comparison
- ΔSA-VA with RV basal septal stimulation vs RV apical stimulation
- AVNRTn = 105
- AVRTn = 130
- Outcome
- Differentiation of AVNRT from AVRT by ΔSA-VAbase vs ΔSA-VAapex
Performance
As reported in the abstract
ΔSA-VA, basal septal vs apical stimulation
| Test or model | ΔSA-VAbase | ΔSA-VAapex | Sensitivity of ΔSA-VAbase ≧85 ms | Specificity of ΔSA-VAbase ≧85 ms |
|---|---|---|---|---|
| AVRT | 44 ± 30 ms | 58 ± 29 ms | ||
| AVNRT | 133 ± 31 ms | 125 ± 25 ms | 97% | 96% |
ΔSA-VAbase
AVRT44 ± 30 ms
AVNRT133 ± 31 ms
ΔSA-VAapex
AVRT58 ± 29 ms
AVNRT125 ± 25 ms
Sensitivity of ΔSA-VAbase ≧85 ms
AVRT— not stated in the abstract
AVNRT97%
Specificity of ΔSA-VAbase ≧85 ms
AVRT— not stated in the abstract
AVNRT96%
Further findings
AP localisation in AVRT by ΔSA-VAbase
- 45-85 ms: left free wall accessory pathways (APs), sensitivity / specificity
- 86% / 95%
- 20-45 ms: posterior septal APs, sensitivity / specificity
- 72% / 96%
- <20 ms: right free wall or anterior/mid septal APs, sensitivity / specificity
- 86% / 98%
Original publication
The Value of Programmed Ventricular Extrastimuli From the Right Ventricular Basal Septum During Supraventricular Tachycardia. JACC Clin Electrophysiol. Published 26 October 2022. doi:10.
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