{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:44:00Z","timestamp":1760147040595,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Determining the mechanism of supraventricular tachycardias with prolongedP ventriculoatrial (VA) intervals is sometimes a challenge. Our objective is to analyse the determinants, time course and diagnostic accuracy (atypical atrioventricular nodal reentrant tachycardias [AVNRT] versus orthodromic reentrant tachycardias through an accessory pathway [ORT]) of spontaneous VA intervals variation in patients with narrow QRS tachycardias and prolonged VA. Methods: A total of 156 induced tachycardias were studied (44 with atypical AVNRT and 112 with ORT). Two sets of 10 measurements were performed for each patient\u2014after tachycardia induction and one minute later. VA and VV intervals were determined. Results: The difference between the longest and the shortest VA interval (Dif-VA) correlates significantly with the diagnosis of atypical AVNRT (C coefficient = 0.95 and 0.85 after induction and at one minute, respectively; p &lt; 0.001). A Dif-VA \u2265 15 ms presents a sensitivity and specificity for atypical AVNRT of 50% and 99%, respectively after induction, and of 27% and 100% one minute later. We found a robust and significant correlation between the fluctuations of VV and VA intervals in atypical AVNRTs (Coefficient Rho: 0.56 and 0.76, after induction and at one minute, respectively; p &lt; 0.001 for both) but not in ORTs. Conclusions: The analysis of VA interval variability after induction and one minute later correctly discriminates atypical AVNRT from ORT in almost all cases.<\/jats:p>","DOI":"10.3390\/jcm12020409","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T05:02:30Z","timestamp":1672808550000},"page":"409","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous Variation of Ventriculo-Atrial Interval after Tachycardia Induction: Determinants and Usefulness in the Diagnosis of Supraventricular Tachycardias with Long Ventriculoatrial Interval"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9673-3062","authenticated-orcid":false,"given":"Olga","family":"Dur\u00e1n-Bobin","sequence":"first","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"},{"name":"Cardiology Department, University Hospital \u201cLucus Augusti\u201d, 27002 Lugo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Mor\u00ed\u00f1igo","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"S\u00e1nchez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto","family":"Bravo","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"},{"name":"Cardiology Department, University Hospital \u201cFundaci\u00f3n Jim\u00e9nez D\u00edaz\u201d, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Fern\u00e1ndez-Portales","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital \u201cSan Pedro de Alc\u00e1ntara\u201d, 10071 C\u00e1ceres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Oterino","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Cruz","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Gonz\u00e1lez-Juanatey","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Hospital \u201cLucus Augusti\u201d, 27002 Lugo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro L.","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Jim\u00e9nez-Candil","sequence":"additional","affiliation":[{"name":"Cardiology Department, IBSAL\u2014University Hospital, CIBER-CV, 37007 Salamanca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"ref_1","first-page":"1072","article-title":"Spanish Catheter Ablation Registry. 20th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020)","volume":"74","year":"2021","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.hrthm.2006.02.019","article-title":"First postpacing interval after tachycardia entrainment with correction for atrioventricular node delay: A simple maneuver for differential diagnosis of atrioventricular nodal reentrant tachycardias versus orthodromic reciprocating tachycardias","volume":"3","author":"Arenal","year":"2006","journal-title":"Heart Rhythm."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hadid, C., Celano, L., Di Toro, D., Antezana-Chavez, E., Gallino, S., Iralde, G., Calvo, D., Avila, P., Atea, L., and Gonzalez, S. (J. Interv. Card. Electrophysiol., 2022). Variability of the VA interval at tachycardia induction: A simple method to differentiate orthodromic reciprocating tachycardia from atypical atrioventricular nodal reentrant tachycardia, J. Interv. Card. Electrophysiol., in press.","DOI":"10.1007\/s10840-022-01376-w"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"161","DOI":"10.7326\/0003-4819-91-2-161","article-title":"Ventriculoatrial intervals: Diagnostic use in paroxysmal supraventricular tachycardia","volume":"91","author":"Benditt","year":"1979","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1540-8159.1984.tb05659.x","article-title":"Diagnosis of concealed accessory pathways in supraventricular tachycardia","volume":"7","author":"Ross","year":"1984","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/europace\/eut100","article-title":"Classification of electrophysiological types of atrioventricular nodal re-entrant tachycardia: A reappraisal","volume":"15","author":"Katritsis","year":"2013","journal-title":"Europace"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/0735-1097(92)90021-E","article-title":"Characteristics of local electrogram predicting successful transcatheter radiofrequency ablation of left-sided accessory pathways","volume":"20","author":"Chen","year":"1992","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_8","unstructured":"Josephson, M.E. (2002). Electrophysiologic investigation: General concepts. Clinical Cardiac Electrophysiology; Techniques and Interpretation, Lippincott Williams & Wilkins."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/pace.14540","article-title":"Discrimination of atypical atrioventricular nodal reentrant tachycardia from atrial tachycardia by the V-A-A-V response","volume":"45","author":"Kaneko","year":"2022","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1161\/01.CIR.88.6.2623","article-title":"Ventricular fusion during resetting and entrainment of orthodromic supraventricular tachycardia involving septal accessory pathways. Implications for the differential diagnosis with atrioventricular nodal reentry","volume":"88","author":"Ormaetxe","year":"1993","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/S0735-1097(00)00770-1","article-title":"Diagnostic value of tachycardia features and pacing maneuvers during paroxysmal supraventricular tachycardia","volume":"36","author":"Knight","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1161\/CIRCEP.115.002949","article-title":"Differential Responses of the Septal Ventricle and the Atrial Signals During Ongoing Entrainment: A Method to Differentiate Orthodromic Reciprocating Tachycardia Using Septal Accessory Pathways From Atypical Atrioventricular Nodal Reentry","volume":"8","author":"Calvo","year":"2015","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1093\/europace\/eux368","article-title":"Delta of the local ventriculo-atrial intervals at the septal location to differentiate tachycardia using septal accessory pathways from atypical atrioventricular nodal re-entry","volume":"20","author":"Calvo","year":"2018","journal-title":"Europace"},{"key":"ref_14","unstructured":"Zipes, D.P., and Jalife, J. (2000). Mechanism of AV Nodal Excitability and Propagation. Cardiac Electrophysiology. From Cell to Bedside, W.B. Saunders Company."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1540-8167.1994.tb01117.x","article-title":"Dynamic behavior of the atrioventricular node: A functional model of interaction between recovery, facilitation, and fatigue","volume":"5","author":"Billette","year":"1994","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_16","unstructured":"Josephson, M.E. (2002). Supraventricular Tachycardias. Clinical Cardiac Electrophysiology. Techniques and Interpretation, Lippincott Williams and Wilkins."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1016\/S0735-1097(98)00433-1","article-title":"Heterogeneity of anterograde fast-pathway and retrograde slow-pathway conduction patterns in patients with the fast-slow form of atrioventricular nodal reentrant tachycardia: Electrophysiologic and electrocardiographic considerations","volume":"32","author":"Nawata","year":"1998","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1161\/01.CIR.93.5.960","article-title":"Heterogeneity of retrograde fast-pathway conduction pattern in patients with atrioventricular nodal reentry tachycardia: Observations by simultaneous multisite catheter mapping of Koch\u2019s triangle","volume":"93","author":"Anselme","year":"1996","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/S0735-1097(98)00576-2","article-title":"Variation of P-QRS relation during atrioventricular node reentry tachycardia","volume":"33","author":"Taniguchi","year":"1999","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2979","DOI":"10.1111\/jce.15242","article-title":"Pacing site- and rate-dependent shortening of retrograde conduction time over the slow pathway after atrial entrainment of fast-slow atrioventricular nodal reentrant tachycardia","volume":"32","author":"Kaneko","year":"2021","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1111\/jce.14501","article-title":"Unique electrophysiological properties of fast-slow atrioventricular nodal reentrant tachycardia characterized by a shortening of retrograde conduction time via a slow pathway manifested during atrial induction","volume":"31","author":"Tamura","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1111\/j.1540-8167.2011.02020.x","article-title":"Differences in ventriculoatrial intervals during entrainment and tachycardia: A simpler method for distinguishing paroxysmal supraventricular tachycardia with long ventriculoatrial intervals","volume":"22","author":"Almendral","year":"2011","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1093\/europace\/euaa283","article-title":"Mechanism and interpretation of two-for-one response to premature atrial complexes during atrioventricular node re-entry tachycardia","volume":"23","author":"Gilge","year":"2021","journal-title":"Europace"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1093\/europace\/eup163","article-title":"Electrophysiology: It is time to simplify!","volume":"11","author":"Mont","year":"2009","journal-title":"Europace"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/2\/409\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:58:38Z","timestamp":1760119118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/2\/409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12020409"],"URL":"https:\/\/doi.org\/10.3390\/jcm12020409","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,1,4]]}}}