The Hemodynamic Mechanism of Pounding in the Neck in Atrioventricular Nodal Reentrant Tachycardia

Abstract

ALTHOUGH the diagnosis of atrioventricular nodal reentrant tachycardia is made on the basis of electrophysiologic criteria, the symptoms and results of physical examination in patients with this arrhythmia may differ from those in patients with other forms of supraventricular tachycardia.^{1 2 3 4} The present study suggests that among patients with supraventricular tachycardia, only those with atrioventricular nodal reentrant tachycardia feel pounding in the neck during the arrhythmia. They also have higher right atrial pressures and more pronounced reversal of flow in the superior and inferior vena cava during atrial systole than patients with other forms of supraventricular tachycardia. The feeling of regular, rapid pounding in the neck may help the physician make the diagnosis of atrioventricular nodal reentrant tachycardia.