The Retrograde P‐Wave Theory: Explaining ST Segment Depression in Supraventricular Tachycardia by Retrograde AV Node Conduction

Rivera, Santiago; Ricapito, María de la Paz; Conde, Diego; Verdu, Mariano Badra; Roux, Jean François; Paredes, Félix Ayala

doi:10.1111/pace.12394

Cited by 10 publications

(7 citation statements)

References 17 publications

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“…Some previous studies have reported a correlation between ST depression during supraventricular tachycardia and heart rate, while some others did not . In our study, patients with ST‐segment depression had a higher arrhythmic rate ( p = 0.044).…”

Section: Discussioncontrasting

confidence: 64%

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Evaluation of left ventricular longitudinal deformation in patients with and without ST segment depression during supraventricular tachycardia

Shaabani

Sadeghian

Hosseinsabet

2017

J of Clinical Ultrasound

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Section: Discussioncontrasting

confidence: 64%

“…Other possible theories concerning the development of ST depression during these arrhythmias are worthy of consideration. They include the fusion of retrograde P wave and ST segment, increased total atrial activation time and ventriculoatrial interval, and decreased systolic blood pressure after the initiation of arrhythmia …”

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular longitudinal deformation in patients with and without ST segment depression during supraventricular tachycardia

Shaabani

Sadeghian

Hosseinsabet

2017

J of Clinical Ultrasound

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“…In AVNRT, the interval is usually below 70 ms, affecting only the QRS complex. 20 The most probable explanation of the findings In our study group, the myocardial ischemia was unlikely to occur, due to the short-lasting arrhythmia paroxysms, relatively young age of the subjects and lack of patients' complaints. In AVNRT, the overlapping of retrograde P waves could not be explained.…”

Section: Discussionmentioning

confidence: 66%

ST-segment depression in atrioventricular nodal reentrant tachycardia: Preliminary results

Mercik¹,

Radziejewska

Pach

et al. 2021

Adv Clin Exp Med

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“…This is why in AVNRT its influence alter rather the shape of the QRS complex – the descending arm of the R wave and the S wave than the ST segment. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is usually not visible. [9] Therefore, the most likely explanation for ST-segment depression is related to the overlapping of the individual components of the heart cycle with a sufficiently rapid tachycardia cycle. Thus, the T wave overlaps with the following QRS complex raising the baseline in front of the QRS complex, which results in the visual appearance of ST segment depression.…”

Section: Introductionmentioning

confidence: 99%

ST-segment depression in atrioventricular nodal reentrant tachycardia: Important finding or just an artifact?

et al. 2022

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Background: The ST segment is component of the QRS-T complex located between the QRS and the T wave. ST segment changes during tachycardia with narrow QRS mainly takes the form of ST segment depression. This phenomenon is often observed in young healthy people for whom an ischemic background is unlikely. Materials and methods: The study included 104 patients (71 women and 33 men) with paroxysmal narrow QRS complex tachycardia. In all patients electrophysiological study was performed and the diagnosis of atrioventricular nodal reentrant tachycardia was established. The arrhythmogenic substrate was then eliminated successfully by subsequent ablation using radiofrequency energy which confirmed the diagnosis, all patients had measured QRS components – QR, RS and RJ during the tachycardia and during the sinusrhythm. All of the measurements were done in lead V5. Results: The difference RJ-QR during tachycardia and sinus rhythm correlated negatively with tachycardia cycle length (R = 0.356, P = .001), first slowly, then rapidly reaching the cycle value of about 300 ms, then it decreases, stabilizing at the cycle level of about 270. By separating the RJ-QR in tachycardia and in the sinus rhythm from the tachycardia cycle, we can see that the correlation described in this point is largely due to the correlation between the heart rate and RJ-QR length in tachycardia. Conclusions: In patients with atrioventricular nodal reentrant tachycardia, there is a significant ST-segment depression during tachycardia episodes and the degree of this change is related to tachycardia cycle length. The most probable explanation of the ST-segment depression is the overlap of the QRS complex on the preceded T wave. This phenomenon is also influenced by some intrinsic properties of the individual electrocardiogram. It is possible to rule out ischemic origin of the presented ST segment change.

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The Retrograde P‐Wave Theory: Explaining ST Segment Depression in Supraventricular Tachycardia by Retrograde AV Node Conduction

Abstract: STd during SVT is observed at long VA intervals when the retrograde P wave matches the ST segment, without dependence on the TCL. This suggests that STd is not necessarily rate dependent but a result of a fusion between the ST segment and the P wave.

Cited by 10 publications

References 17 publications

Evaluation of left ventricular longitudinal deformation in patients with and without ST segment depression during supraventricular tachycardia

Evaluation of left ventricular longitudinal deformation in patients with and without ST segment depression during supraventricular tachycardia

ST-segment depression in atrioventricular nodal reentrant tachycardia: Preliminary results

ST-segment depression in atrioventricular nodal reentrant tachycardia: Important finding or just an artifact?

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