Clinical, electrocardiographic and electrophysiologic observations in patients with paroxysmal supraventricular tachycardia

Delon Wu*, Pablo Denes, Fernando Amat-Y-Leon, Ramesh Dhingra, Christopher R.C. Wyndham, Robert Bauernfeind, Pervaize Latif, Kenneth M. Rosen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

295 Scopus citations

Abstract

Seventy-nine patients without ventricular preexcitation but with documented paroxysmal supraventricular tachycardia were analyzed. Electrophysiologic studies suggested atrioventricular (A-V) nodal reentrance in 50 patients, reentrance utilizing a concealed extranodal pathway in 9, sinus or atrial reentrance in 7 and ectopic automatic tachycardia in 3. A definite mechanism of tachycardia could not be defined In 10 patients (including 7 whose tachycardia was not inducible). The three largest groups with inducible tachycardias were compared in regard to age, presence of organic heart disease, rate of tachycardia, functional bundle branch block during tachycardia and relation of the P wave and QRS complex during tachycardia. A-V nodal reentrance was characterized by a narrow QRS complex and a P wave occurring simultaneously with the QRS complex during tachycardia. Reentrance utilizing a concealed extranodal pathway was characterized by young age, absence of organic heart disease, fast heart rate, presence of bundle branch block during tachycardia and a P wave following the QRS complex during tachycardia. Sinoatrial reentrance was characterized by frequent organic heart disease, a narrow QRS complex and a P wave in front of the QRS complex during tachycardia. In conclusion, a mechanism of paroxysmal supraventricular tachycardia could be defined in most patients. Observations of clinical and electrocardiographic features in these patients should allow prediction of the mechanism of the tachycardia.

Original languageEnglish
Pages (from-to)1045-1051
Number of pages7
JournalAmerican Journal of Cardiology
Volume41
Issue number6
DOIs
StatePublished - 22 05 1978
Externally publishedYes

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