A Composite Electrophysiological Descriptor of Atrioventricular Nodal Conduction and Non-inducible Atrioventricular Nodal Reentrant Tachycardia: Findings from a Retrospective Electrophysiological Cohort.

Authors

Aykan Çelik, Uğur Kocabaş, Elif Naz Uçak, Ali Efe Afşin, Tuncay Kırış, Mustafa Karaca

Published in

Anatolian journal of cardiology. Aug 27, 2026. Epub Aug 27, 2026.

Abstract

To examine whether a simple electrophysiological descriptor derived from routinely measured antegrade atrioventricular nodal conduction parameters is associated with non-inducible atrioventricular nodal reentrant tachycardia (AVNRT).
This retrospective cohort included 387 consecutive patients undergoing electrophysiological study for clinically suspected AVNRT. The Total Antegrade Nodal Delay (TAND) index was defined as the sum of the atrio-His (AH) interval and antegrade Wenckebach cycle length (WBCL). Logistic regression, receiver operating characteristic analysis, and quadrant-based continuum analysis were performed. Because WBCL values were missing predominantly in inducible patients, complete-case and sensitivity analyses were conducted.
Non-inducible AVNRT occurred in 106 patients (27.4%). In the complete-case TAND cohort (n = 329), higher TAND values were associated with non-inducibility (odds ratio [OR] per 50-ms increase: 1.26, 95% CI: 1.02-1.56, P = .032), remaining significant after adjustment for age and sex (adjusted OR: 1.31, 95% CI: 1.05-1.63, P = .016). Discrimination was modest (area under the curve: 0.592, 95% CI: 0.525-0.659). After multiple imputation, the association remained directionally consistent but was attenuated (adjusted OR: 1.21, 95% CI: 0.99-1.46, P = .056). Quadrant analysis demonstrated a graded increase in non-inducibility from the low-AH/low-WBCL to the high-AH/high-WBCL quadrant (25.0% vs. 42.3%; trend OR: 1.32, 95% CI: 1.07-1.61, P = .008).
Total Antegrade Nodal Delay was modestly associated with non-inducible AVNRT and may describe a group-level electrophysiological pattern characterized by slower antegrade nodal conduction and higher functional conduction thresholds. However, TAND should not be interpreted as a mechanistic requirement for AVNRT inducibility or as an individual-level prediction tool.

PMID:
42656079
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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