Usefulness of ST-segment elevation in lead aVR during tachycardia for determining the mechanism of narrow QRS complex tachycardia

Yi Lwun Ho, Lian Yu Lin, Jiunn Lee Lin, Ming Fong Chen, Wen Jone Chen, Yuan Teh Lee

研究成果: 雜誌貢獻文章同行評審

20 引文 斯高帕斯(Scopus)

摘要

In the present study, we analyzed ST-segment elevation in lead aVR during tachycardia to differentiate the narrow QRS complex tachycardia. A total of 338 12-lead electrocardiograms during narrow QRS complex tachycardia were analyzed. Each patient underwent a complete electrophysiologic study. There were 161 episodes of atrioventricular nodal reentrant tachycardia (AVNRT), 165 episodes of atrioventricular reciprocating tachycardia (AVRT), and 12 episodes of atrial tachycardia (AT). The prevalence of aVR ST-segment elevation was 71% for AVRT, 31% for AVNRT, and 16% for AT. For ST-T changes in different leads, logistic regression analysis showed aVR ST-segment elevation was the only significant factor to differentiate the types of narrow QRS complex tachycardia (p <0. 001 for AVRT and AVNRT; p = 0.02 for AVRT and AT). The sensitivity, specificity, and accuracy of aVR ST-segment elevation to differentiate AVRT from AVNRT and AT were 71%, 70%, and 70%, respectively. Among 117 episodes of AVRT with aVR ST-segment elevation, there were 76 (65%) left side, 23 (20%) right side, 14 (12%) posterior septal, and 4 (3%) antero- and mid-septal accessory pathways (p = 0.002). In conclusion, aVR ST-segment elevation during narrow QRS complex tachycardia favors the atrioventricular reentry through an accessory pathway as the mechanism of the tachycardia.
原文英語
頁(從 - 到)1424-1428
頁數5
期刊American Journal of Cardiology
92
發行號12
DOIs
出版狀態已發佈 - 12月 15 2003
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學

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