A constant postpacing interval in response to overdrive pacing with variable number of beats: An aid in the identification of entrainment for a particular pacing train during macroreentrant atrial tachycardias

Background When pacing trains with a constant cycle length (CL) but increasing number of beats are introduced during a macroreentrant atrial tachycardia (MAT), the postpacing interval (PPI) is expected to increase if entrainment does not occur but could be stable if entrainment occurs. We tested the...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2019-12, Vol.30 (12), p.2657-2667
Main Authors: Arceluz, Martín R., Barrio, Teresa, Castellanos, Eduardo, Salgado, Ricardo, García, Javier, Lázaro Rivera, Carla, Ortiz, Mercedes, Lucena Pardos, Irené, Almendral, Jesús
Format: Article
Language:English
Subjects:
Arrhythmia
Atria
atrial flutter
atrial tachycardia
Atrium
Electrocardiography
Entrainment
entrainment criteria
macrorrentrant atrial tachycardia
Tachycardia
Vibration
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Summary:Background When pacing trains with a constant cycle length (CL) but increasing number of beats are introduced during a macroreentrant atrial tachycardia (MAT), the postpacing interval (PPI) is expected to increase if entrainment does not occur but could be stable if entrainment occurs. We tested the ability of PPI analysis to detect entrainment. Methods Synchronized pacing trains with increasing number of beats (1‐20) were delivered from the coronary sinus (CS) and lateral right atrium (RA) at a CL 20 ms shorter than the MAT CL. Pacing trains were grouped in pairs differing by one‐paced beat, and the ∆PPI measured. Results In an initial prospective cohort of 21 patients (48% had left atrial flutter) the mean ∆PPI was 21.3 ± 5.6 ms for pairs of pacing trains in which neither entrained the MAT and 2.8 ± 1.4 ms for those in which both entrained the MAT (P 30 ms, presence vs absence of antiarrhythmic drugs and faster vs slower MAT. When an index pacing train was compared to one with two‐paced beats less, a PPI difference of
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14196