Mechanism of Repolarization Change During Initiation of Supraventricular Tachycardia

Abstract

Repolarization changes during SVT initiation were caused mainly by concurrent hemodynamic change after SVT initiation with abrupt cycle length shortening.

The Retrograde P‐Wave Theory: Explaining ST Segment Depression in Supraventricular Tachycardia by Retrograde AV Node Conduction

“…The myocardium action potential duration (APD) and effective refractory period (ERP) are longer at the epicardium at long cycle lengths, but a crossover of the relation is often encountered so that at short cycle lengths the APD and ERP become longer at the endocardium. In the presence of very short TCL with higher oxygen demands, functional ischemia is present, and endocardial APD could be reduced beyond that of the epicardium, thus generating dispersion of refractoriness accounting for STd in patients with no coronary artery disease (CAD) and very fast tachycardia. This reveals that the STd may be multifactorial.…”

A modified electrocardiographic algorithm for differentiating typical atrioventricular node re-entrant tachycardia from atrioventricular reciprocating tachycardia mediated by concealed accessory pathway

“…We also proved that this phenomenon indicated AVRT as the mechanism of tachycardia. By contrast, the mechanism of ST‐segment depression during supraventricular tachycardia has not yet been fully understood and many factors may influence the ST‐segment depression (16), especially in adult patients. This may partly explain why the accuracy of our modified algorithm was slightly higher than that of Jaeggi's algorithm used in this study and in a similar studied population by Arya et al (10).…”

Evaluation of left ventricular longitudinal deformation in patients with and without ST segment depression during supraventricular tachycardia

“…Other possible theories concerning the development of ST depression during these arrhythmias are worthy of consideration. They include the fusion of retrograde P wave and ST segment, increased total atrial activation time and ventriculoatrial interval, and decreased systolic blood pressure after the initiation of arrhythmia …”