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Local V-A Index For the Differential Diagnosis of Supraventricular Tachycardia

dc.rights.licenseopenen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBOUYER, Benjamin
dc.contributor.authorDERVAL, Nicolas
dc.contributor.authorPAMBRUN, Thomas
dc.contributor.authorTIXIER, Romain
dc.contributor.authorARNAUD, Marine
dc.contributor.authorBULIARD, Samuel
dc.contributor.authorCHAUVEL, Remi
dc.contributor.authorMARCHAND, Hugo
dc.contributor.authorBOUTEILLER, Xavier
dc.contributor.authorVLACHOS, Kostantinos
dc.contributor.authorASCIONE, Ciro
dc.contributor.authorYOKOYAMA, Masaaki
dc.contributor.authorKOWALEWSKI, Christopher
dc.contributor.authorHOCINI, Meleze
dc.contributor.authorJAIS, Pierre
dc.contributor.authorSACHER, Frederic
dc.contributor.authorHAISSAGUERRE, Michel
dc.contributor.authorDUCHATEAU, Josselin
dc.date.accessioned2024-02-21T15:51:18Z
dc.date.available2024-02-21T15:51:18Z
dc.date.issued2024-01-27
dc.identifier.issn1556-3871en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/188301
dc.description.abstractEnBACKGROUND: Differentiating between atypical atrioventricular node re-entrant tachycardia (aAVNRT) and orthodromic reciprocating tachycardia (ORT) utilizing a septal accessory pathway is a complex challenge. OBJECTIVE: We introduce the "local VA index," a straightforward method based on signals from the coronary sinus (CS) catheter, to distinguish between these arrhythmias during tachycardia and entrainment. The V-A interval on the CS catheter is measured during tachycardia and entrainment, at the site of earliest atrial activity. The difference between these two situations defines the "local VA index". Additionally, we propose a mechanism to clarify the limitations of historical pacing maneuvers, such as PPI-TCL and SA-VA, by examining nodal decrement and intraventricular conduction delay. METHODS: In a retrospective study involving 75 patients referred for supraventricular tachycardia (SVT) evaluation, 37 were diagnosed with AVRT with ORT, and 38 with AVNRT (27 typical, 11 atypical). RESULTS: In comparison to AVRT patients, AVNRT patients exhibited longer PPI-TCL (176±47ms vs. 113±42ms; p<0.01) and SA-VA (138±47ms vs. 64±28ms; p<0.01). The AVRT group had a mean local V-A index of -1 ± 13ms, while the AVNRT group had a significantly longer index of 91 ± 46ms (p<0.01). An optimal threshold for differentiation was a local VA index of 40ms. Importantly, there was no significant correlation between pacing cycle length and nodal decrement, as well as intraventricular delay related to pathway location. This interindividual variability might explain misleading interpretations of PPI-TCL and SA-VA. CONCLUSION: This novel approach is advantageous due to its simplicity and effectiveness, requiring only two diagnostic catheters. A local VA interval difference of less than 40ms provides a clear distinction for AVRT.
dc.language.isoENen_US
dc.subject.enAVNRT
dc.subject.enAVRT
dc.subject.enSVT
dc.subject.enelectrophysiology.
dc.title.enLocal V-A Index For the Differential Diagnosis of Supraventricular Tachycardia
dc.title.alternativeHeart Rhythmen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.hrthm.2024.01.042en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed38286245en_US
bordeaux.journalHeart Rhythmen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamAHEAD_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-04471514
hal.version1
hal.date.transferred2024-02-21T15:51:21Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&amp;rft_val_fmt=info:ofi/fmt:kev:mtx:journal&amp;rft.jtitle=Heart%20Rhythm&amp;rft.date=2024-01-27&amp;rft.eissn=1556-3871&amp;rft.issn=1556-3871&amp;rft.au=BOUYER,%20Benjamin&amp;DERVAL,%20Nicolas&amp;PAMBRUN,%20Thomas&amp;TIXIER,%20Romain&amp;ARNAUD,%20Marine&amp;rft.genre=article


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