Age-Related Changes in the Anatomy of the Triangle of Koch: Implications for Catheter Ablation of Atrioventricular Nodal Re-entry Tachycardia
| Autor: | Yidi Jiang, Thea Lee, Ilan Lashevsky, Atul Verma, Eugene Crystal, Adam Korogyi, Anura Malaweera, Benedict Glover, Maria Terricabras, Joy Sumin Park, Grace Huang, Kathryn L. Hong, Eduardo Sanhueza, Dragana Skobic |
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| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
medicine.medical_specialty business.industry medicine.medical_treatment Re entry Catheter ablation Ablation Bundle of His Ostium medicine.anatomical_structure RC666-701 Internal medicine cardiovascular system medicine Cardiology Diseases of the circulatory (Cardiovascular) system Original Article cardiovascular diseases medicine.symptom Cardiology and Cardiovascular Medicine NODAL business Coronary sinus |
| Zdroj: | CJC Open CJC Open, Vol 3, Iss 7, Pp 924-928 (2021) |
| ISSN: | 2589-790X |
| DOI: | 10.1016/j.cjco.2021.03.007 |
| Popis: | Background: Atrioventricular nodal re-entrant tachycardia is the most common type of paroxysmal supraventricular tachycardia. We sought to assess whether important anatomic factors, such as the location of the slow pathway, proximity to the bundle of His, and coronary sinus ostium dimensions, varied with patient age, and whether these factors had an impact on procedural duration, acute success, and complications. Methods: Baseline demographic and procedural data were collected, and the maps were analyzed. Linear regression models were performed to evaluate the associations between age and these anatomic variations. Associations were also assessed, with age categorized as being ≥ 60 years or < 60 years. Results: The slow pathway was more commonly located in a superior location relative to the coronary sinus ostium in older patients. The location of the slow pathway moved in a superior direction by 1 mm for every increase in 2 years from the mean estimate of age. Additionally the slow pathway tended to be closer to the coronary sinus ostium in older patients, and the diameter of the ostium was larger in older patients. This resulted in longer procedure time, longer ablation times, and a greater need for long sheaths for stability. Conclusions: The location of the slow pathway becomes more superior and closer to the coronary sinus ostium with increasing age. Additionally, the coronary sinus diameter increases with age. These factors result in longer ablation and procedural times in older patients. Résumé: Contexte: La tachycardie par réentrée nodale auriculoventriculaire est le type le plus fréquent de tachycardie supraventriculaire paroxystique. Nous avons voulu évaluer si des facteurs anatomiques importants, tels que l'emplacement de la voie lente, la proximité du faisceau de His et les dimensions de l'orifice du sinus coronaire (ostium), variaient avec l’âge, et si ces facteurs avaient un effet sur la durée de l'intervention, le succès à court terme et les complications. Méthodologie: Des données sur les caractéristiques démographiques initiales et l'intervention ont été recueillies, et les cartes obtenues ont été analysées. Des modèles de régression linéaire ont servi à déterminer les corrélations entre l’âge et ces variations anatomiques. Les corrélations ont aussi été évaluées selon des catégories d’âge, soit ≥ 60 ans et |
| Databáze: | OpenAIRE |
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