RT-46
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Ventricular repolarization
abnormalities during and after paroxysmal supraventricular tachycardia
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Nelly Paparella, Giuseppe Fuca,
Riccardo Cappato*, Feifan Ouyang*, Paolo Alboni.
Division of Cardiology, Ospedale Civile, Cento, Italy,
* II Med ABT - AK St. George, Hamburg, Germany
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Abstract
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Background. ST segment alterations
during paroxysmal supraventricular tachycardia have been little investigated. The purpose
of the present study was to systematically investigate the ST segment depression during
spontaneous reentrant supraventricular tachycardia.
Methods. We investigate 102 patients with spontaneous
supraventricular tachycardia and narrow QRS complexes. The ST-T segment alterations during
tachycardia were analyzed in the 12 leads electrocardiogram.
Results. The mean age was 52 yrs (range 8-84 yrs), 68 were female, 15
patients (15%) had organic heart disease. An AV nodal tachycardia was present in 74
patients and an AV reentrant tachycardia in 28. The tachycardia duration was 136 ± 190
min (range from 1 min to 16 hours) and the heart rate was 176 ± 28 bpm. An ST segment
depression> 1 mm in one or more leads was present in 67 patients (66%). Age,
sex, presence of organic heart disease, heart rate, duration and type of reentrant
tachycardia did not significantly differ between patients with and without ST segment
depression, even if it was more marked in the patients with heart disease. The ST segment
depression showed a correlation, even if slight, only with the tachycardia heart rate (r =
0.26, p = 0.03).
Conclusions. It has been previously reported that ST segment
depression is a common finding during supraventricular tachycardia and it si not related
to coronary disease. We found an ST depression in about 70% of the patients. It is not an
expression of underlying heart disease, but it seems to be, at least in part, a
rate-related phenomenon that provides no diagnostic informations either regarding the
mechanism of the tachycardia or the presence of underlying heart disease.
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Key Words
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ST-segment alterations
supraventricular tachycardia, ventricular repolarization, OA
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