Journal of Zhejiang University SCIENCE
(ISSN 1009-3095, Monthly)
2002   Vol. 3   No. 5   p.632-635

Value of the adenosine test for diagnosis of dual AV nodal physiology in patients with AV nodal reentrant tachycardia

ZHOU Bin-quan(周斌全)(Dept.of Cardiology, Sir Run Run Shaw Hospital, Medical College, ZheJiang University, Hangzhou 310016,China)  
HU Shen-jiang(胡申江)(Dept. of Cardiology, First Affiliated Hospital,Medical College,Zhejiang University, Hangzhou 310003,China)  
LU Duan(鲁端)(Dept.of Cardiology, Sir Run Run Shaw Hospital, Medical College, ZheJiang University, Hangzhou 310016,China)  
WANG Jian-an(王建安)(Dept.of Cardiology, Sir Run Run Shaw Hospital, Medical College, ZheJiang University, Hangzhou 310016,China)  

Abstract:Objectives: This study was aimed at assessing the value of the adenosine test for noninvasive diagnosis of dual AV nodal physiology(DAVNP) in patients with AV nodal reentrant tachycardia (AVNRT). Methods: 53 patients with paroxysmal supraventricular tachycardia (PSVT) were given incremental doses of adenosine intravenously during sinus rhythm before electrophysiological study. The adenosine test was repeated on a subset of 18 patients with AVNRT after radiofrequency catheter ablation. Results: Sudden increments of PR interval of more than 60 msec between two consecutive beats were observed in 26(83.9%) of 31 patients with typical AVNRT and 2 (9.1%) of 22 patients with AVRT and AT (P<0.01). The maximal PR increment between 2 consecutive beats in the AVNRT group(105±45ms) was significantly greater than that in the AVRT and AT group (20±13ms) (P<0.01).In postablation adenosine test, DAVNP was eliminated in all 8 patients who underwent slow pathway abolition that EPS showed the slow pathway disappeared and 4 of 10 patients who underwent slow pathway modification that EPS showed the slow pathway persisted. Six of 10 patients who exhibited persistent duality showed a marked reduction in the number of beats conducted in the slow pathway after adenosine injection(P<0.01).Conclusions: Administration of adenosine during sinus rhythm may be a useful bedside test for diagnosis of DAVNP in high percentage of patients with typical AVNRT and additionally for evaluating the effects of radiofrequency ablation.
Keywords:Adenosine, Dual AV nodal, Electrophysiology, Tachycardia, AV nodal reentrant

CLC Number:R540.4  Document ID:A

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Manuscript Received:2001 Dec. 5

Manuscript Revised:2002 May 20

Published:2002 Dec. 1