دورية أكاديمية
A Single Atrial Extrastimulation Resetting His Bundle During Supraventricular Tachycardia to Differentiate Atrial Tachycardia.
| العنوان: | A Single Atrial Extrastimulation Resetting His Bundle During Supraventricular Tachycardia to Differentiate Atrial Tachycardia. |
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| المؤلفون: | Inaba O; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan. Electronic address: oinbcvm@tmd.ac.jp., Inamura Y; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Takagi T; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Meguro S; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Nakata K; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Michishita T; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Isonaga Y; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Kono T; Department of Cardiology, Kameda Medical Center, Kamogawa, Japan., Tachibana S; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Ikenouchi T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan., Ohya H; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Murata K; Department of Cardiology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan., Takamiya T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan., Sato A; Department of Cardiology, Japanese Red Cross Saitama Hospital, Saitama, Japan., Sasano T; Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan. |
| المصدر: | JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Jun; Vol. 10 (6), pp. 1120-1131. Date of Electronic Publication: 2024 Mar 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101656995 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-5018 (Electronic) Linking ISSN: 2405500X NLM ISO Abbreviation: JACC Clin Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, NY] : Elsevier Inc., [2015]- |
| مواضيع طبية MeSH: | Tachycardia, Supraventricular*/diagnosis , Tachycardia, Supraventricular*/physiopathology , Tachycardia, Supraventricular*/therapy , Bundle of His*/physiopathology, Humans ; Male ; Female ; Middle Aged ; Aged ; Prospective Studies ; Adult ; Tachycardia, Atrioventricular Nodal Reentry/diagnosis ; Tachycardia, Atrioventricular Nodal Reentry/physiopathology ; Catheter Ablation/methods ; Electrocardiography ; Heart Atria/physiopathology |
| مستخلص: | Background: Catheter ablation is the curative treatment for paroxysmal supraventricular tachycardia (SVT). However, atrial tachycardia (AT) diagnosis is often challenging, especially when SVT is terminated by pacing. Objectives: This study sought to develop a novel method for AT diagnosis. Methods: A total of 147 SVTs including 28 ATs, 87 atrioventricular nodal re-entrant tachycardias, and 32 orthodromic reciprocating tachycardias were prospectively studied. Single atrial extrastimulation was performed at the proximal coronary sinus from a coupling interval 20 milliseconds shorter than the tachycardia cycle length and gradually decreased until the His bundle (HB) was first reset and further until the SVT was terminated. The response of the SVT during the first HB resetting and the termination pattern were examined. Results: In 27 of 28 ATs, tachycardia was unaffected when HB resetting whereas, in atrioventricular nodal re-entrant tachycardias or orthodromic reciprocating tachycardias (non-AT), tachycardia was simultaneously reset when HB resetting or was terminated with an atrio-Hisian block. When the coupling interval was further shortened for cases in which tachycardia persisted, all 33 SVTs with tachycardia termination with atrio-Hisian block were non-ATs, whereas 5 ATs and 7 non-ATs were terminated with Hisian-atrial block. The sensitivity, specificity, and positive and negative predictive values of the pattern of tachycardia that was unaffected when HB resetting for AT diagnosis were 96%, 100%, 100%, and 99%, respectively. Those of the pattern of tachycardia termination with atrio-Hisian block for non-AT diagnosis were 92%, 100%, 100%, and 42%, respectively. Conclusions: Single atrial extrastimulation from the proximal coronary sinus during tachycardia was useful and effective for AT diagnosis. Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: His bundle resetting; atrial tachycardia; single atrial extrastimulation; supraventricular tachycardia; tachycardia termination |
| تواريخ الأحداث: | Date Created: 20240329 Date Completed: 20240626 Latest Revision: 20240626 |
| رمز التحديث: | 20240627 |
| DOI: | 10.1016/j.jacep.2024.02.007 |
| PMID: | 38551549 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2405-5018 |
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| DOI: | 10.1016/j.jacep.2024.02.007 |