title: Diagnostic Accuracy of Several Electrocardiographic Criteria for the Prediction of Atrioventricular Nodal Reentrant Tachycardia.
abstract: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT) whose diagnosis can be strongly suspected based on the surface eletrocardiogram alone. The purpose of this study is to determine the diagnostic accuracy of several electrocardiographic (ECG) criteria for the prediction of AVNRT.
  
  
  
  Between November 2010 and January 2014, a total of 256 patients who underwent electrophysiological testing (EP) with regular, paroxysmal and narrow QRS complex tachycardia were prospectively enrolled. We classified the ECG recordings during tachycardia for the presence of the following criteria: a) classical ECG findings of pseudo S wave in inferior leads and/or pseudo r' wave in lead V1, b) notch in lead aVL, c) no retrograde P waves visible during tachycardia; d) pseudo r' wave in lead aVR, e) notch in lead D1, f) any deflection after 100 ms of the QRS complex during tachycardia.
  
  
  
  On multivariate analysis, independent predictors of AVNRT diagnosis were female sex (OR 4.17; 95% CI [2.11-8.24]; p <0.001), age >60 years (OR 3.53; 95% CI [1.25-9.96]; p = 0.017) and the classical ECG criteria (OR 7.41; 95% CI [3.62-15.17]; p <0.001).
  
  
  
  Female, age >60 years and the classical ECG criteria were the independent predictors of AVNRT diagnosis. Although several of the ECG criteria for AVNRT diagnosis showed acceptable sensitivities and specificities, they do not improve its accuracy.
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil. Electronic address: jumedeiros@terra.com.br.
authors.forename: Juliana
authors.initials: J
authors.lastname: Filgueiras Medeiros
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Fábio Martins
authors.initials: FM
authors.lastname: Nardo-Botelho
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Lara Cristina
authors.initials: LC
authors.lastname: Felix-Bernardes
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Hollanda-Oliveira
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Bassolli de Oliveira-Alves
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Ênia
authors.initials: Ê
authors.lastname: Lúcia-Coutinho
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Dietrich
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Adriano
authors.initials: A
authors.lastname: Caixeta
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Jose Marconi
authors.initials: JM
authors.lastname: Almeida-de-Sousa
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Ântonio
authors.initials: Â
authors.lastname: Carlos-Carvalho
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Cirenza
authors.affiliation: Department of Cardiology, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.
authors.forename: Ângelo Amato
authors.initials: ÂA
authors.lastname: Vicenzo-de-Paola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult
keywords: Ablation; Atrioventricular nodal reentrant tachycardia; Tachyarrhythmia; Tachycardia