Premature atrial complex with P'R prolongation indicates multiple atrioventricular nodal pathways.
BACKGROUND
The goal of the present study was to test if ambulatory Holter recordings can predict the electrophysiologic study (EPS) findings in patients with supraventricular tachycardia (SVT).


RESULTS
The study involved 110 patients with SVT who underwent Holter recording, and then EPS. The hypotheses were that (1) a P'R interval of premature atrial complexes (PACs) between 280 and 400 ms in the Holter recordings predicted dual atrioventricular nodal (AVN) pathways, (2) P'R interval >400 ms predicted triple or more AVN pathways, and (3) SVT initiated by a single PAC suggested easy SVT induction during the EPS. The EPS revealed dual AVN pathways in 14 (93%) of 15 patients with P'R intervals between 280 and 400 ms on the Holter recordings, and triple or more AVN pathways in 18 (90%) of 20 patients with P'R intervals >400 ms. In addition, a single extrastimulus easily induced SVT during the EPS in 11 (85%) of 13 patients in whom SVT was initiated by a single PAC during Holter recording.


CONCLUSIONS
The ambulatory Holter recording criteria specifically predicted the EPS findings, thereby providing useful advance information.
Fukuda
Etsuko
E
The Cardiovascular Institute, Tokyo, Japan. etsukof@cvi.or.jp
Yamashita
Takeshi
T
Tamakoshi
Kumiko
K
Sagara
Kouichi
K
Iinuma
Hiroyuki
H
Aizawa
Tadanori
T
Fu
Long-Tai
LT
D000368:Aged; D018880:Atrial Premature Complexes / Q000175:diagnosis / Q000503:physiopathology*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged