The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

Maruyama, Mitsunori; Kobayashi, Yoshinori; Miyauchi, Yasushi; T, Ino; Atarashi, Hirotsugu; Katoh, Takao; Mizuno, Kyoichi

doi:10.1111/j.1540-8167.2007.00928.x

Cited by 76 publications

(60 citation statements)

References 18 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have utilized overdrive atrial pacing from different sites. One study has shown that a difference in VA R and VA T of less than 14 milliseconds when performing differential pacing from high right atrium and proximal CS is diagnostic of AVNRT or AVRT and excludes all patients with AT . In our patient the corresponding values with these two maneuvers are 0 milliseconds (160–160 milliseconds) and 1 millisecond (161–160 milliseconds), respectively.…”

Section: Commentarymentioning

confidence: 99%

Atrial Overdrive Pacing: Is VA Linking Present?

Leventopoulos

Yue

2015

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Atrial tachycardia, AV node reentry, entrainmentA 57-year-old patient presented with narrow-complex tachycardia (NCT) without discernable P waves on the ECG. He had previously undergone an aortic root and aortic valve replacement 6 years before. At electrophysiological studies, baseline measurements of AH and HV were 92 and 46 milliseconds, respectively. A stable and sustained NCT at the cycle length (CL) of 302 milliseconds was readily inducible. There was 1:1 atrioventricular relationship with a VA interval at the proximal coronary sinus (CS) of 160 milliseconds. Ventricular overdrive pacing (VOP) at a cycle length of 280 milliseconds resulted in VA block and failed to entrain the atrium. Atrial overdrive pacing (AOP) at 280 milliseconds was then performed at the high septal right atrium and coronary sinus ostium (Fig. 1A,B). Is VA linking demonstrated by this pacing maneuver? CommentaryVA block during VOP excludes AVRT and strongly favors AT, 1 but AVNRT with retrograde block in the lower common pathway 2 is a potential differential diagnosis. AOP to assess for VA linking by comparing the VA interval on the first return beat to the VA during tachycardia can be useful to differentiate AVNRT (presence of VA linking with difference <10 milliseconds) from atrial tachycardia (absence of VA linking).3 However, VA linking could exist coincidentally in AT, and repeating this maneuver at different AOP CLs and from different atrial sites has been proposed to increase its predictive value. 1In panel A, atrial activation at the CS during AOP precedes the pacing stimulus, which represents a very long intra-atrial conduction time from the high right atrial septum to the CS ostium, and suggests a macroreentrant atrial tachycardia mechanism. Measurement of the V-V intervals following AOP confirms that the last entrained ventricular beat should

show abstract

Section: Commentarymentioning

confidence: 99%

Atrial Overdrive Pacing: Is VA Linking Present?

Leventopoulos

Yue

2015

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…Thus, at least in electrophysiology, change is good. Diagnostic criteria have been developed for the many changes that occur during an SVT study—changing from sinus rhythm to SVT; the onset of burst pacing from ventricle or atrium during SVT; resumption of tachycardia at the end of burst pacing during SVT from ventricle or atrium; delivery of extrastimuli from ventricle or atrium during SVT; spontaneous variation in SVT cycle length; development or relief of bundle branch block during SVT; response to drug administration; and termination of SVT to sinus rhythm . At least 40 different pacing maneuvers or observations have been described in this area.…”

Section: Editorial Commentmentioning

confidence: 99%

Back to Basics: The Value of Simple Diagnostic Maneuvers in Diagnosing Supraventricular Tachycardias

Miller

Maskoun

2013

Cardiovasc electrophysiol

View full text Add to dashboard Cite

“…38,39 DIFFERENTIAL-SITE ATRIAL PACING. Rapid atrial pacing results in overdrive suppression of the AT rate.…”

Section: Diagnostic Maneuvers During Tachycardia Atrial Extrastimulatmentioning

confidence: 99%

Focal Atrial Tachycardia

Issa

2012

Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease

View full text Add to dashboard Cite

The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

Abstract: The delta-VA interval was useful for diagnosing AT irrespective of patient conditions such as ventriculoatrial conduction.

Cited by 76 publications

References 18 publications

Atrial Overdrive Pacing: Is VA Linking Present?

Atrial Overdrive Pacing: Is VA Linking Present?

Back to Basics: The Value of Simple Diagnostic Maneuvers in Diagnosing Supraventricular Tachycardias

Focal Atrial Tachycardia

Contact Info

Product

Resources

About