title: Simplified automated right ventricular overdrive pacing for rapid diagnosis of supraventricular tachycardia.
abstract: OBJECTIVE
  The purpose of this study was to prospectively evaluate the feasibility and diagnostic value of right ventricular overdrive pacing (RVOP) during supraventricular tachycardia (SVT) using a 2-catheter approach with automatic pacing from the right ventricular inflow (RVIT) and outflow tract (RVOT).
  
  
  METHODS
  One hundred and thirty-six consecutive patients (with 138 arrhythmias, mean age 36 ± 20 years, range 4-95) were enrolled in this study. Only coronary sinus and ablation catheters were used. RVOP was delivered from RVIT and then from RVOT. Each attempt consisted of 10 synchronized beats delivered at a cycle length of 10-40 ms longer than the tachycardia cycle length.
  
  
  RESULTS
  RVOP was sufficient to confirm the transition zone within the first 9 beats in the majority of SVTs. Atrial perturbation (acceleration, delayed) in the transition zone was detected in all patients with orthodromic atrioventricular (AV) reentry. Patients with typical AV nodal reentry, atypical AV nodal reentry and atrial tachycardia did not show atrial timing perturbation during fusion complexes of RVOP.
  
  
  CONCLUSIONS
  Synchronized RVOP from RVIT or RVOT is an easy and accurate method for the quick and reliable differential diagnosis of SVT in various clinical settings, particularly when only a limited number of catheters are used.
authors.affiliation: Department of Electroradiology, Institute of Nursing and Health Sciences, University of Rzeszow, Rzeszow, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Stec
authors.forename: Janusz
authors.initials: J
authors.lastname: Sledź
authors.forename: Mariusz
authors.initials: M
authors.lastname: Mazij
authors.forename: Bartosz
authors.initials: B
authors.lastname: Ludwik
authors.forename: Michał
authors.initials: M
authors.lastname: Labus
authors.forename: Jerzy
authors.initials: J
authors.lastname: Spikowski
authors.forename: Lesław
authors.initials: L
authors.lastname: Szydłowski
authors.forename: Monika
authors.initials: M
authors.lastname: Klank-Szafran
authors.forename: Ewa
authors.initials: E
authors.lastname: Kraszewska
authors.forename: Adam S
authors.initials: AS
authors.lastname: Budzikowski
mesh_terms: D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology