DOI: 10.36347/sjams.2022.v10i11.029

Pages: 1976-1981

Background: Reciprocating atrioventricular tachycardia can be categorized into common slow–fast atrioventricular node re-entrant (AVNRT) and orthodromic atrioventricular reciprocating tachycardia (AVRT). The electrocardiogram (ECG) during tachycardia is useful in distinguishing these two mechanisms. The presence of a pseudo- R0-wave in lead V1 or pseudo-S-wave in the inferior leads has been widely used, although the value of an isolated aVL lead has not been evaluated yet. To determine whether an isolated aVL lead of the surface 12-lead ECG is useful for the differential diagnosis between AVNRT and AVRT. Methods: This cross sectional observational study was conducted at the department of Cardiology, National Institute of Cardiovascular Diseases & Hospital, for 1-year period. Patient admitted in NICVD due to supraventricular tachycardia and was screened as a case of AVNRT & AVRT were approached for inclusion of the study. After initial management all patients were subjected to perform electrophysiological study and radiofrequency ablation. The specific pattern of changes in aVL lead were recorded in each cases and were analyze to determine the sensitivity, specificity and positive predictive values to estimate AVRT & AVNRT. Informed written consent was taken from the subject and ethical issues were ensured. Total 60 patients were included for final analysis. Data analysis was done by statistical program Statistical Package for Social Science (SPSS) version 20.0. Results: Among the 60 study population, mean age was 41.28±11.21 SD (years) [age range: 18-65 years]. Total 44 patients (73%) had AVNRT and 16 patients (27%) had found AVRT in Electrophysiological evaluation. About 61.7% patients were female and 38.3% patients were male in this study with no significant gender difference in between AVNRT and AVRT group (p>0.05). Total 43.3% patients had aVL notch on ECG. Among patients who had AVNRT, 54.5% had aVL notch and among patients who had AVRT, 12.5% had aVL .........