EXAMINATION OF RESTING ELECTROCARDIOGRAMS OF PATIENTS WITH ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA AND ITS UTILIZATION IN DIFFERENTIAL DIAGNOSIS OF COMMON AND UNCOMMON SUBTYPES
O.C. Yontar, A. Erdem, U. Kutuk
Bursa Postdoctorate Training and Research Hospital, Bursa, Turkey
Introduction: AVNRT is the most common subgroup of regular SVT. There are two types of AVNRT: common and uncommon. Our aim is to determine particular resting ECG abnormalities in patients with AVNRT and identify if there is a difference between common and uncommon AVNRT in this field.
Methods: Records of Sivas Numune Hospital from January 2010 to October 2012 were retrospectively examined. ST and T wave abnormality on twelve-lead resting ECG were classified according to location as 1) DII-III and aVF, 2) DI and aVL, 3) V4-6 leads. Negative T wave and/or ?1 mm ST depressions were accepted as deviations.
Results: Common AVNRT patients had abnormality mostly on DII-III and aVF (75%) while uncommon group rather had on DI and aVL (80%) (p=0,000). Linear regression analysis showed that, among all other variables (age, sex, hypertension and diabetes) only ECG abnormality subtype was an independent predictor for discriminating typical from atypical AVNRT.
Conclusions: Common AVNRT seems to be associated with II-III-aVF derivations whereas uncommon AVNRT is more likely associated with I and aVL (p=0,000). We suggest that resting ECG is important in decision making for a patient with SVT who is planned for electrophysigical testing. ST and/or T wave deviations on particular ECG derivations may aid for preprocedural planning and preparation of clinicians.
Figure 1. Resting twelve lead electrocardiogram of a patient who later diagnosed as common AVNRT. Arrows indicate nonspecific ST segment depressions especially on leads III and aVF.
Figure 2. Same patient’s twelve lead electrocardiogram during supraventricular tachycardia. Arrows indicate rate-induced typical ST segment depression.
