creators_name: Belhassen, Bernard
creators_name: Fish, Roman
creators_name: Viskin, Sami
creators_name: Glick, Aharon
creators_name: Glikson, Michael
creators_name: Eldar, Michael
editors_name: Singh, Balbir
editors_name: Lokhandwala, Yash
editors_name: Francis, Johnson
editors_name: Gupta, Anup
type: journalp
datestamp: 2005-05-02
lastmod: 2011-03-11 08:56:01
metadata_visibility: show
title: Incidence of Dual AV Node Physiology Following Termination of AV Nodal Reentrant Tachycardia by Adenosine-5'-Triphosphate: A Comparison with Drug Administration in Sinus Rhythm
ispublished: pub
subjects: ipej
full_text_status: public
keywords: Adenosine triphosphate; AV nodal reentrant tachycardia; dual AV node physiology
abstract: Administration of adenosine triphosphate (ATP) in sinus rhythm identifies dual atrioventricular node physiology (DAVNP) in 75% of patients with inducible slow / fast AV nodal reentrant tachycardia (AVNRT). The incidence of DAVNP following termination of AVNRT with ATP is unknown. Incremental doses of ATP (10-60mg) were administered, first in sinus rhythm and then during tachycardia induced at electrophysiologic study, to 84 patients with inducible AVNRT and to 18 control patients with inducible AV reentrant tachycardia (AVRT) and no electrophysiologic evidence of DAVNP. Study end-points were the occurrence of DAVNP or > 2nd degree AV block following administration of ATP in sinus rhythm and tachycardia termination following administration of ATP during tachycardia. Of the 82 patients with AVNRT who completed the study, 62 (75.6%) exhibited DAVNP following administration of 17.1 + 9.4 mg ATP in sinus rhythm, while 30 (36.5%) exhibited DAVNP at the termination of AVNRT following administration of 10.6 + 2.4 mg ATP. The occurrence of DAVNP following the administration of 10 mg ATP in sinus rhythm.was a good predictor (62%) of its occurrence after termination of AVNRT with ATP. The dose of ATP had a strong correlation between the presence of DAVNP following AVNRT termination and the ATP doses needed for tachycardia termination. Of the 18 control patients, none had DAVNP at ATP test during sinus rhythm but 1 (5.5%) showed slight (60 msec) PR jump after termination of AVRT with ATP. In conclusion, DAVNP is present in a relatively high proportion (36.5%) of patients following termination of AVNRT with ATP but is much less frequent (5.5%) in control patients. Thus, findings at termination of tachycardia by ATP may be useful in the noninvasive diagnosis of the mechanism of a paroxysmal supraventricular tachycardia. 
date: 2003-01
date_type: published
publication: Indian Pacing and Electrophysiology Journal
volume: 3
number: 1
publisher: Indian Pacing and Electrophysiology Group
pagerange: 3-9
refereed: TRUE
referencetext: 1. Belhassen B, Glick A, Laniado S. Comparative clinical and electrophysiologic effects of adenosine triphosphate and verapamil on paroxysmal reciprocating junctional tachycardia. Circulation. 1988;77:795-805.

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6. Tebbenjohanns J, Niehaus M, Korte T, Drexler H. Noninvasive diagnosis in patients with undocumented tachycardias: value of the adenosine test to predict AV nodal reentrant tachycardia. J Cardiovasc Electrophysiol 1999;10:916-923.

7. Waxman MB, Sharma AD, Cameron DA, Cameron DA, Huerta F, Wald RF. Reflex mechanisms responsible for early spontaneous termination of paroxysmal supraventricular tachycardia. Am J Cardiol 1982;49:259-272. 

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citation:   Belhassen, Bernard and Fish, Roman and Viskin, Sami and Glick, Aharon and Glikson, Michael and Eldar, Michael  (2003) Incidence of Dual AV Node Physiology Following Termination of AV Nodal Reentrant Tachycardia by Adenosine-5'-Triphosphate: A Comparison with Drug Administration in Sinus Rhythm.  [Journal (Paginated)]     
document_url: http://cogprints.org/4291/1/belhassen.htm