1. Mechanism of Repolarization Change During Initiation of Supraventricular Tachycardia
- Author
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Yoga Yuniadi, Yenn-Jiang Lin, Shih-Ann Chen, Jen-Yuan Kuo, Bien-Hsien Huang, Kun-Tai Lee, Tu-Ying Liu, Pi-Chiang Lee, Ching-Tai Tai, and Chen-En Chiang
- Subjects
Adult ,Male ,Tachycardia ,medicine.medical_specialty ,Pre-Excitation Syndromes ,Benign early repolarization ,Electrocardiography ,Heart Conduction System ,Physiology (medical) ,Internal medicine ,Tachycardia, Supraventricular ,medicine ,Humans ,Repolarization ,ST segment ,cardiovascular diseases ,skin and connective tissue diseases ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Electrophysiology ,Anesthesia ,cardiovascular system ,Cardiology ,Female ,sense organs ,Supraventricular tachycardia ,Electrical conduction system of the heart ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,AV nodal reentrant tachycardia - Abstract
Repolarization Changes During SVT. Introduction: Previous literature has documented the association between narrow QRS supraventricular tachycardia (SVT) and pronounced ST-T segment change. The aim of this study was to evaluate repolarization changes during SVT initiation and demonstrate the possible mechanism. Methods and Results: Fifty-one consecutive patients (20 men and 31 women; mean age 46.1 ′ 16.4 years) with narrow QRS SVT (32 patients with AV nodal reentrant tachycardia and 19 patients with AV reentrant tachycardia) were included. We retrospectively analyzed the intracardiac recordings and ST-T segment changes on 12-lead surface ECGs during SVT initiation. Twenty-six (51%) patients developed ST segment repolarization changes during SVT initiation. Patients with shorter baseline sinus cycle length, shorter tachycardia cycle length, elevated systolic blood pressure before tachycardia induction, and greater reduction of systolic blood pressure had a higher incidence of repolarization changes. However, multivariate analysis showed that reduction of systolic blood pressure after SVT induction was the only independent predictor of repolarization changes. Furthermore, the maximal degree of ST segment depression during SVT correlated with the reduction of systolic blood pressure (r = 0.75, P < 0.001). Conclusion: Repolarization changes during SVT initiation were caused mainly by concurrent hemodynamic change after SVT initiation with abrupt cycle length shortening.
- Published
- 2004