AVNRT Slow/Slow

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Characteristics

1. Dual AV Nodal Physiology and jump with initiation
2. Retrograde VA > 60 ms
3. AH > HA
4. Earliest Atrial Activation in posterior septal region

Diferentiation of AVNRT Slow/Slow from AVRT with AVRT using a Concealed Bypass Tract

• P wave morphology
  • Negative in the Inferior Leads in both
  • Positive in AVNRT Slow/Slow and Positive or biphasic in AVRT using a Posterior Septal Concealed Bypass Tract
• Delta RP (V1-II) > 25 ms
• Delta RP (V1-III) > 23 ms
• Delta RP (V1 - aVF) > 30ms

References

1. Oh et al. Differential Diagnosis of Slow/ Slow AVNRT from AVRT using a Concealed Bypass Tract by 12 Lead ECG. PACE. 2003; 26:2296-2300