1. Diagnostic Accuracy of Several Electrocardiographic Criteria for the Prediction of Atrioventricular Nodal Reentrant Tachycardia
- Author
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Lucas Bassolli de Oliveira-Alves, Jose Marconi Almeida-de-Sousa, Ênia Lúcia-Coutinho, Ântonio Carlos-Carvalho, Juliana Filgueiras Medeiros, Adriano Caixeta, Fábio Martins Nardo-Botelho, Lucas Hollanda-Oliveira, Ângelo Amato Vicenzo-de-Paola, Cristiano de Oliveira Dietrich, Lara Cristina Felix-Bernardes, and Claudio Cirenza
- Subjects
Adult ,Male ,Tachycardia ,medicine.medical_specialty ,Adolescent ,Diagnostic accuracy ,Paroxysmal supraventricular tachycardia ,030204 cardiovascular system & hematology ,Narrow QRS complex ,Sensitivity and Specificity ,Electrocardiography ,Young Adult ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Heart Conduction System ,Internal medicine ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Medicine ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Child ,Aged ,business.industry ,Female sex ,General Medicine ,Middle Aged ,Ecg findings ,Child, Preschool ,Multivariate Analysis ,cardiovascular system ,Cardiology ,Female ,medicine.symptom ,business - Abstract
Background and Aims Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT) whose diagnosis can be strongly suspected based on the surface eletrocardiogram alone. The purpose of this study is to determine the diagnostic accuracy of several electrocardiographic (ECG) criteria for the prediction of AVNRT. Methods Between November 2010 and January 2014, a total of 256 patients who underwent electrophysiological testing (EP) with regular, paroxysmal and narrow QRS complex tachycardia were prospectively enrolled. We classified the ECG recordings during tachycardia for the presence of the following criteria: a) classical ECG findings of pseudo S wave in inferior leads and/or pseudo r′ wave in lead V1, b) notch in lead aVL, c) no retrograde P waves visible during tachycardia; d) pseudo r′ wave in lead aVR, e) notch in lead D1, f) any deflection after 100 ms of the QRS complex during tachycardia. Results On multivariate analysis, independent predictors of AVNRT diagnosis were female sex (OR 4.17; 95% CI [2.11–8.24]; p 60 years (OR 3.53; 95% CI [1.25–9.96]; p = 0.017) and the classical ECG criteria (OR 7.41; 95% CI [3.62–15.17]; p Conclusions Female, age >60 years and the classical ECG criteria were the independent predictors of AVNRT diagnosis. Although several of the ECG criteria for AVNRT diagnosis showed acceptable sensitivities and specificities, they do not improve its accuracy.
- Published
- 2016