Comparison of standard and Lewis ECG in detection of atrioventricular dissociation in patients with wide QRS tachycardia
| Autor: | Serdar Sevimli, Oktay Gulcu, Emrah Ipek, Enbiya Aksakal, Selim Topcu, Uğur Aksu, Mahmut Acikel, Ibrahim Halil Tanboga, Kamuran Kalkan |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Tachycardia medicine.medical_specialty Wide QRS Tachycardia 030204 cardiovascular system & hematology Lewis lead Ventricular tachycardia Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine medicine Humans In patient Prospective Studies cardiovascular diseases 030212 general & internal medicine Atrioventricular dissociation Electrodes Aged medicine.diagnostic_test business.industry Middle Aged medicine.disease Heart Block Tachycardia Ventricular Cardiology Female Differential diagnosis medicine.symptom Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 225:4-8 |
| ISSN: | 0167-5273 |
| Popis: | Background The atrioventricular (AV) dissociation, which is frequently used in differential diagnosis of wide QRS complex tachycardia (WQCT), is the most specific finding of ventricular tachycardia (VT) with lower sensitivity. Herein, we aimed to show the importance of Lewis lead ECG records to detect ‘visible p waves' during WQCT. Method A total of 21 consecutive patients who underwent electrophysiologic study (EPS) were included in the study. During EPS, by using a quadripolar diagnostic catheter directed to the right ventricular apex, a fixed stimulus was given and the ventriculoatrial (VA) Wenkebach point was found, and a VT was simulated by a RV apical stimulus at 300ms. The standard and Lewis lead ECG records were taken during this procedure. Result We detected ‘visible p waves' in 7 (33.3%) and 14 (66.7%) patients in the standard and Lewis lead ECG groups, respectively. In terms of the ‘visible p waves', there was a statistically significant difference between groups ( p =0.022). The sensitivity of standard and Lewis lead ECG in determination of the visible p waves was 33.3% and 66.7%, respectively. Conclusion The Lewis lead ECG can be more informative about AV dissociation than the standard 12 lead ECG. As a result, we could suggest the assessment of the Lewis lead ECG recording in addition to the standard 12 lead ECG in differential diagnosis of VT in patients with WQCT. |
| Databáze: | OpenAIRE |
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