本研究旨在评估当前诊断标准的性能，并确定与房室结折返性心动过速（AVNRT）区分具有隐匿性结室/结束（NV/NF）通路的直行往复式心动过速（ORT）的其他电生理特征。
尽管存在室房传导阻滞（VAB），但诊断持续性室上性心动过速（SVT）仍具有挑战性。
我们分析了具有VAB的25个持续SVT（9个NV/NF-ORT[n=7/2]和16个AVNRT）和不具有VAB的91个AVNRT的电描记图（供参考）。
超过1个SVT,每个都有不同的心室房间隔，通常在AVNRT病例中诱发（75％），但在NV/NF-ORT病例中未诱发（0％；p=0.0005）。WenckebachVAB在NV/NF-ORT中很常见（78％），但VAB模式在AVNRT中有所不同。在大多数AVNRT中，VAB后的搏动中，His-His间隔暂时延长，但在NV/NF-ORT中很少（79％vs.22%；p=0.01）。NV/NF-ORT通过His难治性室性早搏（n=5）和右心室超速起搏期间的发现诊断为未校正/校正的起搏后间期（PPI）-心动过速周期长度（TCL）≤115/110ms（n=5/5），直行捕获（n=6），和V-V-A（心室-心室-心房反应）反应（n=3）。单一形式的诱导SVT（阳性预测值[PPV]：69％；阴性预测值[NPV]：100％），WenckebachVAB(PPV:70%；NPV:87%)，尽管VAB（PPV：70％；NPV：85％），但His-His间隔稳定，直行捕获（PPV：100％；NPV：97％），和V-V-A反应（PPV：100％；NPV：95％）表征NV/NF-ORT，PPI-TCL≤125ms(PPV:100%;NPV:100%)表征为NV-ORT。
诱导单一SVT形式，WenckebachVAB,尽管VAB，他-他的间隔时间稳定，他的捕获，和V-V-A反应似乎区分NV/NF-ORT和AVNRT，PPI-TCL≤125ms，区分NV-ORT与NF-ORT和AVNRT。
This study sought to assess the performance of current diagnostic criteria and identify additional electrophysiological features differentiating orthodromic reciprocating tachycardia (ORT) with a concealed nodoventricular/nodofascicular (NV/NF) pathway from atrioventricular nodal re-entrant tachycardia (AVNRT).
Diagnosing sustained supraventricular tachycardia (SVT) despite the occurrence of ventriculoatrial block (VAB) is challenging.
We analyzed electrograms of 25 sustained SVTs (9 NV/NF-ORTs [n = 7/2] and 16 AVNRTs) with VAB and 91 AVNRTs without VAB (for reference).
More than 1 SVT, each with a different ventriculoatrial interval, was commonly induced in AVNRT cases (75%) but not in NV/NF-ORT cases (0%; p = 0.0005). Wenckebach VAB was common in NV/NF-ORTs (78%), but VAB patterns varied in AVNRTs. The His-His interval transiently prolonged in the following beat after the VAB in most AVNRTs but rarely did in NV/NF-ORTs (79% vs. 22%; p = 0.01). NV/NF-ORT was diagnosed by His-refractory premature ventricular contractions (n = 5) and the findings during right ventricular overdrive pacing showing an uncorrected/corrected post-pacing interval (PPI)-tachycardia cycle length (TCL) ≤115/110 ms (n = 5/5), orthodromic His capture (n = 6), and V-V-A (ventricle-ventricle-atrial response) response (n = 3). A single form of induced SVT (positive predictive value [PPV]: 69%; negative predictive value [NPV]: 100%), Wenckebach VAB (PPV: 70%; NPV: 87%), stable His-His interval despite VAB (PPV: 70%; NPV: 85%), orthodromic His capture (PPV: 100%; NPV: 97%), and V-V-A response (PPV: 100%; NPV: 95%) characterized NV/NF-ORT, and a PPI-TCL of ≤125 ms (PPV: 100%; NPV: 100%) characterized NV-ORT.
Induction of a single SVT form, Wenckebach VAB, stable His-His interval despite VAB, orthodromic His capture, and V-V-A response appeared to discriminate NV/NF-ORT from AVNRT, with a PPI-TCL of ≤125 ms discriminating NV-ORT from NF-ORT and AVNRT.
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