Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia

Introduction and objectives: The stimulus-atrial minus ventriculo-atrial interval (SA-VA) difference during ventricular overdrive pacing of a supraventricular tachycardia is used to differentiate atrioventricular reciprocating tachycardia (AVRT) from atrioventricular nodal re-entrant tachycardia (AV...

ver descrição completa

Detalhes bibliográficos
Autores: Adeliño, Raquel, Bazán, Víctor, Sarrias, Axel, Jiménez-López, Jesús, Aranyó, Júlia, Bisbal, Felipe, Andrés-Cordón, Joan F., Rodríguez-García, Julián, Jordán Marchite, Pablo, Gonzalez-Matos, Carlos E., Villuendas, Roger, Rivas-Gándara, Nuria, Almendral, Jesús
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:dnet:rdupf_______::2fe30b3ebe8c7a85fadd2353a0e12f33
Acesso em linha:https://hdl.handle.net/10230/73042
http://dx.doi.org/10.1016/j.rec.2025.03.005
Access Level:acceso abierto
Palavra-chave:Atrial tachycardia
Cardiac electrophysiologic study
Entrainment maneuvers
Supraventricular tachycardia
id ES_a74fee3a860068bf7aa8f38e1bfb75e5
oai_identifier_str oai:dnet:rdupf_______::2fe30b3ebe8c7a85fadd2353a0e12f33
network_acronym_str ES
network_name_str España
repository_id_str
spelling Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardiaAdeliño, RaquelBazán, VíctorSarrias, AxelJiménez-López, JesúsAranyó, JúliaBisbal, FelipeAndrés-Cordón, Joan F.Rodríguez-García, JuliánJordán Marchite, PabloGonzalez-Matos, Carlos E.Villuendas, RogerRivas-Gándara, NuriaAlmendral, JesúsAtrial tachycardiaCardiac electrophysiologic studyEntrainment maneuversSupraventricular tachycardiaIntroduction and objectives: The stimulus-atrial minus ventriculo-atrial interval (SA-VA) difference during ventricular overdrive pacing of a supraventricular tachycardia is used to differentiate atrioventricular reciprocating tachycardia (AVRT) from atrioventricular nodal re-entrant tachycardia (AVNRT), but positive values have always been reported. In atrial tachycardia, the SA conduction is unrelated to the tachycardia mechanism, allowing for negative SA-VA values. We postulated that a negative SA-VA may serve as a criterion for atrial tachycardia in patients with supraventricular tachycardia and ventricular overdrive pacing from the right ventricular apex. Methods: Multicenter data from ventricular overdrive pacing during atrial tachycardia (from 6 centers) and during AVRT and AVNRT (from 2 centers) were retrospectively and consecutively collected. The correct diagnosis was established using conventional criteria. The SA-VA difference was calculated for each case. The optimal SA-VA cut-off point for the diagnosis of atrial tachycardia was determined. Results: Out of 240 tachycardias analyzed, ventricular overdrive pacing succeeded in accelerating the atria to the pacing rate without tachycardia termination in 106 cases: 38 (36%) AVNRT, 33 (31%) AVRT, and 35 (33%) atrial tachycardias (all exhibiting long VA intervals). All atrial tachycardias had a negative SA-VA value, while all AVNRT and AVRT cases had positive SA-VA values. A SA-VA value lower than 0ms was the best cutoff, with an area under the curve of 1 and 100% sensitivity and specificity for the diagnosis of atrial tachycardia. Conclusions: A negative SA-VA difference is a novel and accurate criterion for the diagnosis of atrial tachycardia with long VA intervals.Elsevier2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/73042http://dx.doi.org/10.1016/j.rec.2025.03.005reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésRevista española de cardiología. 2025;78(12):1024-32© 2025 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:dnet:rdupf_______::2fe30b3ebe8c7a85fadd2353a0e12f332026-06-12T07:21:37Z
dc.title.none.fl_str_mv Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
title Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
spellingShingle Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
Adeliño, Raquel
Atrial tachycardia
Cardiac electrophysiologic study
Entrainment maneuvers
Supraventricular tachycardia
title_short Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
title_full Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
title_fullStr Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
title_full_unstemmed Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
title_sort Negative SA-VA difference during ventricular overdrive pacing of supraventricular tachycardia for the diagnosis of atrial tachycardia
dc.creator.none.fl_str_mv Adeliño, Raquel
Bazán, Víctor
Sarrias, Axel
Jiménez-López, Jesús
Aranyó, Júlia
Bisbal, Felipe
Andrés-Cordón, Joan F.
Rodríguez-García, Julián
Jordán Marchite, Pablo
Gonzalez-Matos, Carlos E.
Villuendas, Roger
Rivas-Gándara, Nuria
Almendral, Jesús
author Adeliño, Raquel
author_facet Adeliño, Raquel
Bazán, Víctor
Sarrias, Axel
Jiménez-López, Jesús
Aranyó, Júlia
Bisbal, Felipe
Andrés-Cordón, Joan F.
Rodríguez-García, Julián
Jordán Marchite, Pablo
Gonzalez-Matos, Carlos E.
Villuendas, Roger
Rivas-Gándara, Nuria
Almendral, Jesús
author_role author
author2 Bazán, Víctor
Sarrias, Axel
Jiménez-López, Jesús
Aranyó, Júlia
Bisbal, Felipe
Andrés-Cordón, Joan F.
Rodríguez-García, Julián
Jordán Marchite, Pablo
Gonzalez-Matos, Carlos E.
Villuendas, Roger
Rivas-Gándara, Nuria
Almendral, Jesús
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Atrial tachycardia
Cardiac electrophysiologic study
Entrainment maneuvers
Supraventricular tachycardia
topic Atrial tachycardia
Cardiac electrophysiologic study
Entrainment maneuvers
Supraventricular tachycardia
description Introduction and objectives: The stimulus-atrial minus ventriculo-atrial interval (SA-VA) difference during ventricular overdrive pacing of a supraventricular tachycardia is used to differentiate atrioventricular reciprocating tachycardia (AVRT) from atrioventricular nodal re-entrant tachycardia (AVNRT), but positive values have always been reported. In atrial tachycardia, the SA conduction is unrelated to the tachycardia mechanism, allowing for negative SA-VA values. We postulated that a negative SA-VA may serve as a criterion for atrial tachycardia in patients with supraventricular tachycardia and ventricular overdrive pacing from the right ventricular apex. Methods: Multicenter data from ventricular overdrive pacing during atrial tachycardia (from 6 centers) and during AVRT and AVNRT (from 2 centers) were retrospectively and consecutively collected. The correct diagnosis was established using conventional criteria. The SA-VA difference was calculated for each case. The optimal SA-VA cut-off point for the diagnosis of atrial tachycardia was determined. Results: Out of 240 tachycardias analyzed, ventricular overdrive pacing succeeded in accelerating the atria to the pacing rate without tachycardia termination in 106 cases: 38 (36%) AVNRT, 33 (31%) AVRT, and 35 (33%) atrial tachycardias (all exhibiting long VA intervals). All atrial tachycardias had a negative SA-VA value, while all AVNRT and AVRT cases had positive SA-VA values. A SA-VA value lower than 0ms was the best cutoff, with an area under the curve of 1 and 100% sensitivity and specificity for the diagnosis of atrial tachycardia. Conclusions: A negative SA-VA difference is a novel and accurate criterion for the diagnosis of atrial tachycardia with long VA intervals.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/73042
http://dx.doi.org/10.1016/j.rec.2025.03.005
url https://hdl.handle.net/10230/73042
http://dx.doi.org/10.1016/j.rec.2025.03.005
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Revista española de cardiología. 2025;78(12):1024-32
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869415768336105472
score 15,812429

Registos relacionados