ST-segment depression in atrioventricular nodal reentrant tachycardia: Preliminary results

Mercik, Jakub; Radziejewska, Jadwiga; Pach, Katarzyna; Zyśko, Dorota; Gajek, Jacek

doi:10.17219/acem/144161

Cited by 2 publications

(4 citation statements)

References 14 publications

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“…A retrograde P wave occurs during AVRT. In orthodromic AVRT, the interval between the QRS complex and the retrograde P wave should be at least 70 ms, depending on the electrophysiological properties of the accessory pathway and the location between pathway and AV node [7]. For this reason, the retrograde P wave is projected onto the ST segment or the T wave.…”

Section: Discussionmentioning

confidence: 99%

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ST segment depression in atrioventricular reentrant tachycardia

Mercik,

Kuniewicz,

Radziejewska

et al. 2023

Eur J Trans Clin Med

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Background: ST segment deviation is common in patients with narrow QRS complex tachycardia. It mainly concerns young people in whom ischemic background is unlikely. In our work we would also like to propose another potential mechanism -the overlapping of individual components of the QRS complex. Material and methods:The study included 11 patients (7 women and 4 men) with paroxysmal narrow QRS complex tachycardia. An electrophysiological study was performed in all patients, the diagnosis of atrioventricular reentrant tachycardia was established and finally successful RF ablation was done. We measured the individual components of QRS QR, RS and RJ during sinus rhythm and during tachycardia. Results: The difference RJ-QR during tachycardia correlated negatively with tachycardia cycle length T(r = -0.85, p = 0.000831 ). We also showed a significant difference between the amplitude of the RJ segment in tachycardia and during sinus rhythm (p = 0.005), at the same time we showed no differences between the amplitude of QR and RS. Conclusions: We showed a statistically significant difference in ST segment depression in correlation with the rate of tachycardia in patients with AVRT resulting mainly from the overlapping of individual components of the QRS complex.

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Section: Discussionmentioning

confidence: 99%

“…We assessed the ECG analogously to our earlier work on AVNRT [6][7]. Figure 1 shows how the individual components of the QRS complex were measured.…”

Section: Methodsmentioning

confidence: 99%

ST segment depression in atrioventricular reentrant tachycardia

Mercik,

Kuniewicz,

Radziejewska

et al. 2023

Eur J Trans Clin Med

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“…In atrioventricular nodal reentrant tachycardia, for example, the ST depression is caused by a retrograde P wave which occurs just after the QRS complex in ECG. A hypothesis that was suggested by Mercik et al [14] is that in rapid enough tachycardia, QRS follows the preceded T wave, which in turn changes the reference point by raising the isoelectric baseline. The overlapping of the R wave on the preceded T wave causes a shortening of the QT interval during tachycardia [14].…”

Section: Discussionmentioning

confidence: 99%

“…A hypothesis that was suggested by Mercik et al [14] is that in rapid enough tachycardia, QRS follows the preceded T wave, which in turn changes the reference point by raising the isoelectric baseline. The overlapping of the R wave on the preceded T wave causes a shortening of the QT interval during tachycardia [14]. As far as we know there is no experimental data regarding the mechanism in AF.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery disease among patients admitted with atrial fibrillation and chest pain

Brezinov

Vorotilina

Vasilenko

et al. 2022

Coronary Artery Disease

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Introduction Patients who present to the emergency department with chest pain during an episode of atrial fibrillation (AF) impose a clinical challenge regarding the source of pain – being coronary artery disease (CAD) or AF in origin. The aim of this study was to identify clinical, imaging or laboratory markers which can predict significant CAD among patients with an AF episode and chest pain. Methods We included 57 consecutive patients admitted to our hospital with AF and chest pain. All patients underwent coronary evaluation. Significant CAD was defined as >50% stenosis in a major coronary artery by coronary angiography or cardiac CT. We compared CAD and non-CAD groups and analyzed risk factorsby regression analysis. Results Twenty-four patients (42%) were diagnosed with- and 33 patients (58%) without obstructive CAD. In a multivariate analysis of regional wall motion abnormality (RWMA), elevated troponin and hypertension were found to be predictors for CAD [odds ratio (OR), 22.4 (confidence interval (CI), 1.8–272.4; P = 0.02); OR, 5.6 (CI, 1–31.0; P = 0.05) and OR, 21.4 (CI, 1.6–284.6; P = 0.02), respectively]. There were no significant differences regarding the rate of typical chest pain at presentation in the CAD vs. the non-CAD group [13 (54%) vs. 20 (60%), P = 0.374], or in ECG ST-changes [12 (50%) vs.9 (27%), respectively; P = 0.08]. Conclusion In patients who present acutely with chest pain and AF, troponin elevation and RWMA appear to be highly predictive of obstructive CAD, whereas clinical symptoms and ECG changes are not predictive. These findings may be helpful for guiding the management of patients admitted with AF and chest pain.

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ST-segment depression in atrioventricular nodal reentrant tachycardia: Preliminary results

Abstract: This research was financially supported by the Ministry of Health subvention (No. STM.A280.20.107 from the IT Simple system of Wroclaw Medical University).

Cited by 2 publications

References 14 publications

ST segment depression in atrioventricular reentrant tachycardia

ST segment depression in atrioventricular reentrant tachycardia

Coronary artery disease among patients admitted with atrial fibrillation and chest pain

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