Clinical impact of "pure" empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on-off tachycardia.

Autor: Gerguri S; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Jathanna N; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Lin T; Heart Care Victoria, Victoria, Australia., Müller P; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Clasen L; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Schmidt J; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Kurt M; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Shin DI; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Blockhaus C; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Kelm M; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Fürnkranz A; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany., Makimoto H; Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. h1sak1mak1m0t0@gmail.com.; Medical Faculty, Cardiovascular Research Institute Duesseldorf (CARID), University Duesseldorf, Duesseldorf, Germany. h1sak1mak1m0t0@gmail.com.
Jazyk: angličtina
Zdroj: European journal of medical research [Eur J Med Res] 2018 Mar 27; Vol. 23 (1), pp. 16. Date of Electronic Publication: 2018 Mar 27.
DOI: 10.1186/s40001-018-0314-0
Abstrakt: Background: Catheter ablation of slow-pathway (CaSP) has been reported to be effective in patients with dual atrioventricular nodal conduction properties (dcp-AVN) and clinical ECG documentation but without the induction of tachycardia during electrophysiological studies (EPS). However, it is unknown whether CaSP is beneficial in the absence of pre-procedural ECG documentation and without the induction of tachycardia during EPS. The aim of this study was to evaluate long-term results after a "pure" empirical CaSP (peCaSP).
Methods: 334 consecutive patients who underwent CaSP (91 male, 47.5 ± 17.6 years) were included in this study. Sixty-three patients (19%) who had no pre-procedural ECG documentation, and demonstrated dcp-AVN with a maximum of one echo-beat were assigned to the peCaSP group. The remaining 271 patients (81%) were assigned to the standard CaSP group (stCaSP). Clinical outcomes of the two groups were compared, based on ECG documented recurrence or absence of tachycardia and patients' recorded symptoms.
Results: CaSP was performed in all patients without any major complications including atrioventricular block. During follow-up (909 ± 435 days), 258 patients (77%) reported complete cessation of clinical symptoms. There was no statistically significant difference in the incidence of AVNRT recurrence between the peCaSP and stCaSP groups (1/63 [1.6%] vs 3/271 [1.1%], P = 0.75). Complete cessation of clinical symptoms was noted significantly less frequently in patients after peCaSP (39/63 [62%] vs 219/271 [81%], P = 0.0013). The incidence of non-AVNRT atrial tachyarrhythmias (AT) was significantly higher in patients after peCaSP (5/63 [7.9%] vs 1/271 [0.4%], P = 0.0011).
Conclusion: A higher incidence of other AT and subjective symptom persistence are demonstrated after peCaSP, while peCaSP improves clinical symptoms in 60% of patients with non-documented on-off tachycardia.
Databáze: MEDLINE
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