SVT Maneuvers

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Contents 1 Baseline Observations during Normal Sinus Rhythm 2 Pacing Maneuvers during Normal Sinus Rhythm 3 Diagnostic Maneuvers during Tachycardia 3.1 Atrial Tachycardia versus AVNRT/AVRT 3.2 AVNRT versus ORT or Atrial Tachycardia 3.3 AVRT with Septal pathway versus Atypical AVNRT 3.4 Atrial Tachycardia versus ORT versus AVNRT

Baseline Observations during Normal Sinus Rhythm

1. Pre-excitation during Sinus Rhythm
2. Spontaneous AV block during tachycardia rules out ORT
3. Spontaneous termination with AV block rules out Atrial Tachycardia
4. Increase in VA interval > 20ms with Bundle Branch Block is diagnostic for ORT

Pacing Maneuvers during Normal Sinus Rhythm

1. VA block during pacing at 600ms makes it unlikely that the tachycardia is ORT
2. Differential Pacing for Posteroseptal pathway
3. Parahisian Pacing for Anteroseptal pathway

Diagnostic Maneuvers during Tachycardia

Atrial Tachycardia versus AVNRT/AVRT

1. VAAV response
2. VA Linking Maneuver

AVNRT versus ORT or Atrial Tachycardia

1. Measure septal VA time. If VA time < 70 ms than it is diagnositic of AVNRT

AVRT with Septal pathway versus Atypical AVNRT

1. PVC on His Maneuver
2. Ventricular Overdrive Maneuver
3. Stimulus to A Maneuver
4. Delta HA Interval

Atrial Tachycardia versus ORT versus AVNRT

1. Measure Delta AH Interval