Title: Diagnosis of supraventricular tachycardia in patients with palpitations by intravenous administration of adenosine triphosphate
Abstract: Objective To assess the value of intravenous administration of adenosine-triphosphate (ATP) during sinus rhythm for identifying patients with palpitations of unclear etiology who might actually have atrioventricular nodal reentrant tachycardia (AVNRT)or atrioventricular reentrant tachycardia (AVRT). Methods Ninety-seven patients with palpitation were enrolled into this study. The first group inoluded 33 patients [13 males,20 females, aged (37 ± 10)years] with palpitation without documented tachycardias. The second group consisted of 64 patients [25 males,39 females,aged (41 ± 12)years] with documented supraventricular tachycardia (SVT) , but unclear mecha-nism. All these patients underwent administration of incremental doses of ATP (5-40 mg)during sinus rhythm and then underwent electrophysiologic study (EPS). Results From the 95 patients who completed the study protocol, a positive ATP test was observed in 67 patients (70.5% ). The positive ATP test included disclosure of atrioventricular node dual pathway (AVNDP)in 44 patients (46.3%)and disclosure of concealed accessory pathway in 23 patients (24.2% ). A negative ATP test was observed in 28 patients (29.5%) . The positive predictive value of a positive ATP test for predicting AVNRT or AVRT was 94% (sensitivity 86.3%). The negative predictive value of the ATP test was 64.3% (specificity 81.6%). Conclusion Administration of ATP during sinus rhythm identifies patients with paipitations who likely have AVNRT or AVRT with a high positive predictive value. This simple test may be a valuable diagnostic tool for identifying the etiology of paipitations.
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: article
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