A simple method to differentiate atrioventricular node reentrant tachycardia from orthodromic recipr

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Background Discrimination between atrioventricular node reentry tachycardia (AVNRT) and orthodromic reciprocating tachycardia (ORT) during electrophysiological study may be challenging.Methods To investigate if the difference of the local VA (ventricle-atrium) interval during entrainment and during tachycardia (DVA, defined as the shortest local VA interval of coronary sinus (CS) during entrainment minus the shortest local VA interval of CS during tachycardia) was different in patients with AVNRT and patients with ORT, 168consecutive patients with supraventricular tachycardias were included.After diagnoses of AVNRT or ORT through a concealed accessory pathway (AP) were made according to conventional electrophysiological criteria, entrainment by right ventricular apex pacing was performed in each patient.The patients with successful entrainment were included in the study.The DVA was compared between patients with AVNRT and patients with ORT.
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