Noninvasive diagnosis of dual AV nodal physiology in patients with AV nodal reentrant tachycardia by adenosine triphosphate test.
Atrioventricular nodal reentrant tachycardia (AVNRT) is a relatively common paroxysmal supraventricular tachycardia. This study investigated whether adenosine-5'-triphosphate (ATP) injection during sinus rhythm might be useful in the noninvasive diagnosis of dual AV nodal pathways. The study group consisted of 9 patients with slow/fast AVNRT and 11 control patients without antegrade dual AV nodal physiology (DAVNP). ATP (2.5 to 30 mg, in 2.5-mg increments was injected during sinus rhythm until signs of DAVNP (> or = 50 msec increase or decrease in AH or PR interval in two consecutive beats) or > or = second-degree AV block was observed. DAVNP was diagnosed by ATP test in all 9 patients with slow/fast AVNRT. DAVNP was observed by ATP test in 3 of the 11 control patients. Thus, the test had a sensitivity of 100% and specificity of 73%. ATP test given during sinus rhythm is useful for identifying patients with dual AV nodal pathways who are prone to AVNRT.
Okumura
Yasuo
Y
Second Department of Medicine, Nihon University School of Medicine Tokyo, Japan.
Watanabe
Ichiro
I
Oshikawa
Naohiro
N
Masaki
Riko
R
Okubo
Kimie
K
Hashimoto
Kenichi
K
Kofune
Tatsuya
T
Yamada
Takeshi
T
Wakita
Rie
R
Takagi
Yasuhiro
Y
Saito
Satoshi
S
Ozawa
Yukio
Y
Kanmatsuse
Katsuo
K
D000255:Adenosine Triphosphate; D000328:Adult; D000368:Aged; D001283:Atrioventricular Node / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000503:physiopathology
D000255:Adenosine Triphosphate