Archives of the Turkish Society of Cardiology
A Method for Evaluating the Success of Slow Pathway Ablation: PR>RR Finding During Rapid Atrial Pacing [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1998; 26(4): 223-227

A Method for Evaluating the Success of Slow Pathway Ablation: PR>RR Finding During Rapid Atrial Pacing

Uğur Kemal TEZCAN1, Hakan TIKIZ1, Ahmet Duran DEMİR1, Yücel BALBAY1, Mustafa SOYLU1, Şule KORKMAZ1, Siber GÖKSEL1

Atrioventricular nodal reentrant tachycardia (A VNRT) occurs ın patients with dua! atrioventricular (AV) nodal physiology. However, dua! AV nodal physiology cannot be demonstrated in a signifıcant proportion of patients w ith A VNRT. During rapid atrial pacing at the maximum rate with consistenı 1:1 AV conduction, PR interval often exeecds the pacing cycle Jength in patients with A VNRT. This finding, deseribed as PR>RR, was proposed to be consistent with antegrade slow pathway conduction and useful method for evaluating the success of slow pathway ablation in patients with A VNRT and without demosırable dua! AV nodal physiology. The purpose of this prospective study was to determine the diagnostic value of the PR>RR find ing as an indicator of antegrade slow pathway conduction and A VNRT. The PR and RR intervals were measured during rapid atrial pacing at the maximum rate with consistent 1:1 AV conduction in 2 groups of patients. Group 1: patients w ith A VNRT (n=20) and Group 2: control subjects (n=2 1 ). Radiofrequency catheter ablation of the slow pathway was performed in all Group 1 patients. After slow pathway ablation, the study protocol was repeated in Group 1 patients. PR>RR finding was present in ıo of 20 Group 1 patients (50%) and 2 of 2ı Group 2 patients (9.5%, p=0.006). After slow pathway ablation, PR>RR finding was no longer preseni in any Group ı patients. The finding of PR>RR had a sensitiviıiy of 50 % for A VNRT, a specificity of 90%, a negative predictive value of 66% and a positive predictive value of 84%. In conclusion, although the sensiıivity of PR>RR finding for AVNRT is low, because of its high specificity and positive predictive value, this finding may be usefuı for evaluating the success of slow pathway ablation in patients with A VNRT in whom tachycardia inducıion is not reproducibe and dua! AV nodal physiology cannot be demonstrated.

Keywords: AV rodal reentrant tachycardia, RF catheter ablation, dual AV pathway.

How to cite this article
Uğur Kemal TEZCAN, Hakan TIKIZ, Ahmet Duran DEMİR, Yücel BALBAY, Mustafa SOYLU, Şule KORKMAZ, Siber GÖKSEL. A Method for Evaluating the Success of Slow Pathway Ablation: PR>RR Finding During Rapid Atrial Pacing. Turk Kardiyol Dern Ars. 1998; 26(4): 223-227
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