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Value of the adenosine test for diagnosis of dual AV nodal physiology in patients with AV nodal reentrant tachycardia

  • Biotechnology & Life Science
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Abstract

Objectives: This study was aimed at assessing the value of the adenosine test for noninvasive diagnosis of dual AV nodal physiology (DAVNP) in patients with AV nodal reentrant tachycardia (AVNRT). Methods: 53 patients with paroxysmal supraventricular tachycardia (PSVT) were given incremental doses of adenosine intravenously during sinus rhythm before electrophysiological study. The adenosine test was repeated on a subset of 18 patients with AVNRT after radiofrequency catheter ablation. Results: Sudden increments of PR interval of more than 60 msec between two consecutive beats were observed in 26 (83.9%) of 31 patients with typical AVNRT and 2 (9.1%) of 22 patients with AVRT and AT (P<0.01). The maximal PR increment between 2 consecutive beats in the AVNRT group (105±45ms) was significantly greater than that in the AVRT and AT group (20±13ms) (P<0.01). In postablation adenosine test, DAVNP was eliminated in all 8 patients who underwent slow pathway abolition that EPS showed the slow pathway disappeared and 4 of 10 patients who underwent slow pathway modification that EPS showed the slow pathway persisted. Six of 10 patients who exhibited persistent duality showed a marked reduction in the number of beats conducted in the slow pathway after adenosine injection (P<0.01). Conclusions: Administration of adenosine during sinus rhythm may be a useful bedside test for diagnosis of DAVNP in high percentage of patients with typical AVNRT and additionally for evaluating the effects of radiofrequency ablation.

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Authors and Affiliations

  1. Dept. of Cardiology, Sir Run Run Shaw Hospital, Medical College, Zhejiang University, 310016, Hangzhou, China

    Zhou Bin-quan, Lu Duan & Wang Jian-an

  2. Dept. of Cardiology, First Affiliated Hospital, Medical College, Zhejiang University, 310003, Hangzhou, China

    Hu Shen-jiang

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  1. Zhou Bin-quan
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  2. Hu Shen-jiang
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  3. Lu Duan
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  4. Wang Jian-an
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Bin-quan, Z., Shen-jiang, H., Duan, L. et al. Value of the adenosine test for diagnosis of dual AV nodal physiology in patients with AV nodal reentrant tachycardia. J. Zhejiang Univ. Sci. A 3, 632–635 (2002). https://doi.org/10.1631/jzus.2002.0632

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  • DOI: https://doi.org/10.1631/jzus.2002.0632

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