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Date Published: 25/03/2024
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DOI: https://doi.org/10.51298/vmj.v536i2.8898
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Vol. 536 No. 2 (2024)
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Phan , Đình P. ., & Nguyễn , M. H. . (2024). THE VALUE OF VENTRICULOATRIAL CONDUCTION PATTERNS IN RESPONSE TO ADENOSINE IN DIFFERENTIAL DIAGNOSIS OF ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA AND ORTHODROMIC RECIPROCATING TACHYCARDIA. Vietnam Medical Journal, 536(2). https://doi.org/10.51298/vmj.v536i2.8898

THE VALUE OF VENTRICULOATRIAL CONDUCTION PATTERNS IN RESPONSE TO ADENOSINE IN DIFFERENTIAL DIAGNOSIS OF ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA AND ORTHODROMIC RECIPROCATING TACHYCARDIA

Đình Phong Phan , Mạnh Hùng Nguyễn

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Abstract

Aims: This study sought to the value of ventriculoatrial (VA) conduction patterns in response to Adenosine in differential diagnosis of atrioventricular nodal reentrant tachycardia (AVNRT) and orthodromic reciprocating tachycardia (ORT). Results: A total of 45 patients between 2022 and 2023, undergoing electrophysiological study is diagnosed as AVNRT or ORT at Cardiovascular center – E hospital, had assessment of VA conduction during ventricular pacing and adenosine administration. Present of block or lengthening of VA conduction had 96% sensitivity and specificity for diagnose AVNRT. One patient with Adenosine-induced VA block and inducible ORT had decremental AP. Adenosine caused VA block in 2 patients with encentric VA activation due to atypical AV nodal conduction. Persistent VA conduction had 94% sensitivity and specificity for diagnose ORT. Concentric VA conduction persisted in 3 patients with septal AP. Adenosine unmasked free-wall APs in 5 patients by blocking AV nodal conduction, shifting VA activation from concentric and fusion to eccentric. Conclusions: The response of VA conduction to Adenosine is a highly sensitive and specificity method for differential diagnosis of AVNRT and ORT. Besides, in cases of VA conduction is contested by AVN, Adenosine-include block VA nodal conduction can delineate the location of AP atrial insertion site.

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References

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