Blood oxygen saturation during atrio-ventricular dissociation with wide-QRS complex tachycardias

Amplitude ratios of two adjacent mixed blood oxygen saturation curve peaks in randomly selected strips of ECG were analysed in 32 patients with regular wide-QRS complex tachycardias and 60 control subjects where pacing was performed before ablation of narrow-QRS complex tachycardias. Patients with VT showed different patterns of A-to-V relationships, leading to varying ratios of SpO2 adjacent peak amplitudes, in contrast to patients with aberrant SVTs and 1 : 1 AV association. Application of a criterion of adjacent SpO2 peaks differing by twofold or more had a sensitivity of 90.0% and specificity of 83.3% to detect AV dissociation during VT. Fluctuations on the mixed oxygen saturation curve may be a useful non-invasive clinical parameter to detect different ventricular filling caused by atrio-ventricular dissociation during VT.