A Study of Narrow Qrs Tachycardia With Emphasis On the Clinical features, ECG, electrophysiology/radiofrequency Ablation

Abstract

Aim: Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) are the most common forms of paroxysmal regular supraventricular tachycardias. Materials & methods: The clinical, ECG and electrophysiological findings of 121 patients with narrow QRS tachycardia were evaluated prospectively. Results: A total of 75 (62%) of the patients had AVNRT while 46 (38%) had AVRT. Pounding sensation in the neck (40 vs 15.2%; p = 0.004), presynope (26.7 vs 56.5%; p = 0.001) identifiable P wave after QRS complex (25.3 vs 73.9%; p = 0.001), pseudo r′/s waves (45.3 vs 4.3%; p = 0.001), limb leads ST-T changes (34.7 vs 60.9%; p = 0.004) were the significant changes observed. A total of 94.7% of AVNRT and 87% of AVRT could be diagnosed correctly considering both clinical and ECG criteria. Conclusion: Pounding sensation in the neck and presyncope along with ECG features like identifiable P wave after QRS complex, pseudo r′/s waves and limb lead ST-T changes very accurately differentiate AVNRT and AVRT.

Keywords:

• atrioventricular nodal reentry tachycardia (AVNRT)
• atrioventricular reentry tachycardia (AVRT)
• electrophysiology (EP) study and radiofrequency ablation (RFA)

Author contributions

The study was approved by the ethical committee of the institute. Written informed consent was taken by all the participants before subjecting them to clinical, ECG and electrophysiological evaluation. The authors report no financial relationships or conflicts of interest regarding the content herein. The paper is not under consideration elsewhere. None of the paper’s contents have been previously published. All authors have read and approved the manuscript. There is no association with any industry and this is not funded by any. No honorarium, grant, or other forms of payment was given to anyone to produce the manuscript. Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript. I will also transfer the rights of the article to the journal upon publication. No conflict of interest among the authors. V Poptani has collected the data. V Poptani and AA Jayaram, S Jain and J Samanth have prepared the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.