Abstract
Abstract
Aim: This study aims to evaluate the outcomes of patients who underwent radiofrequency ablation (RFA) for paroxysmal supraventricular tachycardia (PSVT) at the Cardiology Clinic of Celal Bayar University Faculty of Medicine.
Methods: A total of 156 patients admitted to the clinic for PSVT were retrospectively included in the study. All patients underwent RFA.
Results: Among the patients who underwent RFA, 72% had atrioventricular nodal reentrant tachycardia (AVNRT), 23% had atrioventricular reentrant tachycardia (AVRT), and 5% had atrial tachycardia (AT). Atypical AVNRT was detected in 2.7% of patients (n = 3), and antidromic AVRT in 5.5% (n = 2). Females accounted for 65.3% of the cohort, while males made up 34.7%. The mean age of the study population was 46.2 ± 15.2 years, with the AVRT group being significantly younger (mean age 38.3 ± 13.6 years, p < 0.05). Comorbidities such as coronary artery disease, hypertension, and diabetes mellitus were more prevalent in the AVNRT group than in the AVRT group. Additionally, total cholesterol, LDL cholesterol, neutrophil/lymphocyte ratio, and CRP levels were significantly higher in the AVNRT group (p < 0.05). The most common accessory pathway in the AVRT group was the left lateral pathway (44.4%). Recurrence was observed in two AVNRT patients and one AVRT patient, all of whom underwent successful repeat procedures. Hematoma at the intervention site occurred in four AVNRT patients and was managed conservatively. Permanent pacemaker implantation was required in one patient from each of the AVNRT and AVRT groups. Coronary artery injury necessitating stenting occurred in one AVRT patient.
Conclusion: The treatment outcomes for PSVT patients in our clinic were comparable to those reported in the literature. Our early success rates were higher; however, the limited number of patients included in the study presents a limitation. Technological advancements in 3D mapping systems are expected to further enhance success rates and reduce complications.
Keywords: Paroxysmal supraventricular tachycardia, radiofrequency ablation, cardiac electrophysiology, atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia.
Keywords
Paroxysmal supraventricular tachycardia radiofrequency ablation cardiac electrophysiology atrioventricular nodal reentrant tachycardia atrioventricular reentrant tachycardia atrial tachycardia.
Project Number
20.478.486/2350
References
- 1. Fox DJ, Tischenko A, et al. Supraventricular tachycardia: diagnosis and management. Mayo Clin Proc. 2008 Dec;83(12):1400-11. doi: 10.1016/S0025-6196(11)60791-X. PMID: 19046562.
- 2. Orejarena LA, Vidaillet H Jr, et al. Paroxysmal supraventricular tachycardia in the general population. J Am Coll Cardiol. 1998 Jan;31(1):150-7. doi: 10.1016/s0735-1097(97)00422-1. PMID: 9426034.
- 3. Brugada J, Katritsis DG, et al; ESC Scientific Document Group. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Feb 1;41(5):655-720. doi: 10.1093/eurheartj/ehz467. Erratum in: Eur Heart J. 2020 Nov 21;41(44):4258. PMID: 31504425.
- 4. Helton MR. Diagnosis and Management of Common Types of Supraventricular Tachycardia. Am Fam Physician. 2015;92(9):793-800.
- 5. Peng G, Zei PC. Diagnosis and Management of Paroxysmal Supraventricular Tachycardia. JAMA. 2024;331(7):601-610. doi:10.1001/jama.2024.0076
- 6. Wegner FK, Habbel P, et al. Predictors of AVNRT Recurrence After Slow Pathway Modification. Int Heart J. 2021;62(1):72-77. doi:10.1536/ihj.20-463
- 7. Brembilla-Perrot B, Sellal JM, et al. Recurrences of symptoms after AV node re-entrant tachycardia ablation: a clinical arrhythmia risk score to assess putative underlying cause. Int J Cardiol. 2015;179:292-296. doi:10.1016/j.ijcard.2014.11.071
- 8. Halder A, Vijay S, et al. Clinical profile and electrophysiological characteristics of atypical atrioventricular nodal reentrant tachycardia: A decade's experience. Indian Pacing Electrophysiol J. 2024 Jan-Feb;24(1):25-29. doi: 10.1016/j.ipej.2023.10.004. Epub 2023 Oct 14. PMID: 37839730; PMCID: PMC10928009.
- 9. Marie Decroocq, Louis Rousselet, et al. Periprocedural, early, and long-term risks of pacemaker implantation after atrioventricular nodal re-entry tachycardia ablation: a French nationwide cohort, EP Europace, Volume 22, Issue 10, October 2020, Pages 1526–1536.
- 10. Liao JN, Hu YF, et al. Permanent pacemaker implantation for late atrioventricular block in patients receiving catheter ablation for atrioventricular nodal reentrant tachycardia. Am J Cardiol. 2013;111(4):569-573. doi:10.1016/j.amjcard.2012.11.003
- 11. Hanninen M, Yeung-Lai-Wah N, et al. Cryoablation versus RF ablation for AVNRT: A meta-analysis and systematic review. J Cardiovasc Electrophysiol. 2013;24(12):1354-1360. doi:10.1111/jce.12247
- 12. Zeljković I, Đula K, et al. High prevalence of hyperlipidaemia in patients with AV re-entry tachycardia and AV nodal re-entry tachycardia. Sci Rep. 2019 Aug 8;9(1):11502. doi: 10.1038/s41598-019-47940-9. PMID: 31395917; PMCID: PMC6687730.
- 13. Porter MJ, Morton JB, et al. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm. 2004;1(4):393-396. doi:10.1016/j.hrthm.2004.05.007
- 14. Aman Chugh, Fred Morady. Preexcitation, Atrioventricular Reentry, and Variants, Editor(s): Douglas P. Zipes, José Jalife, William G. Stevenson, Cardiac Electrophysiology: From Cell to Bedside (Seventh Edition), Elsevier, 2018, Pages 736-745, ISBN 9780323447331,https://doi.org/10.1016/B978-0-323-44733-1.00077-8.
- 15. O'Hara GE, Philippon F, et al. Catheter ablation for cardiac arrhythmias: a 14-year experience with 5330 consecutive patients at the Quebec Heart Institute, Laval Hospital [published correction appears in Can J Cardiol. 2009 Mar;25(3):140]. Can J Cardiol. 2007;23 Suppl B(Suppl B):67B-70B. doi:10.1016/s0828-282x(07)71013-9.
- 16. Bhaskaran A, Chik W, et al. A review of the safety aspects of radio frequency ablation. Int J Cardiol Heart Vasc. 2015;8:147-153. Published 2015 Jun 9. doi:10.1016/j.ijcha.2015.04.011
- 17. Fredrik Holmqvist, Milos Kesek, et al. A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes, European Heart Journal, Volume 40, Issue 10, 07 March 2019, Pages 820–830, https://doi.org/10.1093/eurheartj/ehy709
- 18. Kurt C. Roberts-Thomson, Peter M. Kistler, et al. Atrial Tachycardia: Mechanisms, Diagnosis, and Management. Current Problems in Cardiology, Volume 30, Issue 10, 2005, Pages 529-573, 7. ISSN 0146-2806, https://doi.org/10.1016/j.cpcardiol.2005.06.004..
- 19. Shehata M, Liu T, et al. Atrial tachycardia originating from the left coronary cusp near the aorto-mitral junction: anatomic considerations. Heart Rhythm. 2010;7(7):987-991. doi:10.1016/j.hrthm.2010.03.017.
- 20. Rosso R, Kistler PM. Focal atrial tachycardia. Heart. 2010;96(3):181-185. doi:10.1136/hrt.2008.143552
- 21. Gonzalez MD, Contreras LJ, Jongbloed MR, et al. Left atrial tachycardia originating from the mitral annulus-aorta junction. Circulation. 2004;110(20):3187-3192. doi:10.1161/01.CIR.0000147613.45259.D1
Abstract
Öz
Amaç: Bu çalışma, Celal Bayar Üniversitesi Tıp Fakültesi Kardiyoloji Kliniği’nde paroksismal supraventriküler taşikardi (PSVT) nedeniyle radyofrekans ablasyonu (RFA) uygulanan hastaların sonuçlarını değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: PSVT nedeniyle kliniğe başvuran toplam 156 hasta retrospektif olarak çalışmaya dahil edilmiştir. Tüm hastalara RFA uygulanmıştır.
Bulgular: RFA uygulanan hastaların %72’sinde atriyoventriküler nodal reentran taşikardi (AVNRT), %23’ünde atriyoventriküler reentran taşikardi (AVRT), ve %5’inde atriyal taşikardi (AT) tespit edilmiştir. Hastaların %2.7’sinde (n = 3) atipik AVNRT, %5.5’inde (n = 2) antidromik AVRT saptanmıştır. Kadın hastalar %65.3, erkek hastalar %34.7 oranındadır. Çalışmaya dahil edilen hastaların yaş ortalaması 46.2 ± 15.2 yıl olup, AVRT grubunda yaş ortalaması 38.3 ± 13.6 yıl ile diğer iki gruba kıyasla anlamlı derecede daha genç bulunmuştur (p < 0.05). Koroner arter hastalığı, hipertansiyon ve diabetes mellitus AVNRT grubunda, AVRT grubuna göre daha sık görülmüştür. Toplam kolesterol, LDL kolesterol, nötrofil/lenfosit oranı ve CRP düzeyleri de AVNRT grubunda, AVRT grubuna göre anlamlı olarak daha yüksek saptanmıştır (p < 0.05). AVRT grubunda en sık sol lateral aksesuar yol (%44.4) gözlenmiştir. Nüks, AVNRT grubunda iki, AVRT grubunda bir hastada görülmüş ve bu hastalara tekrar işlem uygulanmıştır. AVNRT grubunda dört hastada girişim bölgesinde hematom gelişmiş ve konservatif olarak takip edilmiştir. Atipik AVNRT üç hastada, AVRT ve AVNRT gruplarından birer hastada kalıcı pacemaker implantasyonu ihtiyacı gelişmiştir. Ayrıca AVRT grubunda bir hastada stent gerektiren koroner arter yaralanması gözlenmiştir.
Sonuç: Kliniğimizde PSVT hastaları literatürde bildirilen oranlarla benzer şekilde tedavi edilmiştir. Erken dönem başarı oranlarımız literatüre göre daha yüksek bulunmuştur; ancak çalışmaya dahil edilen hasta sayısının sınırlı olması bir dezavantajdır. 3D haritalama sistemlerindeki teknolojik gelişmelerle birlikte başarı oranlarının daha da artacağı ve komplikasyonların azalacağı açıktır.
Anahtar Kelimeler: Paroksismal supraventriküler taşikardi, radyofrekans ablasyon, kardiyak elektrofizyoloji, atriyoventriküler nodal reentran taşikardi, atriyoventriküler reentran taşikardi, atriyal taşikardi.
Keywords
Paroksismal supraventriküler taşikardi radyofrekans ablasyon kardiyak elektrofizyoloji atriyoventriküler nodal reentran taşikardi atriyoventriküler reentran taşikardi atriyal taşikardi.
Project Number
20.478.486/2350
References
- 1. Fox DJ, Tischenko A, et al. Supraventricular tachycardia: diagnosis and management. Mayo Clin Proc. 2008 Dec;83(12):1400-11. doi: 10.1016/S0025-6196(11)60791-X. PMID: 19046562.
- 2. Orejarena LA, Vidaillet H Jr, et al. Paroxysmal supraventricular tachycardia in the general population. J Am Coll Cardiol. 1998 Jan;31(1):150-7. doi: 10.1016/s0735-1097(97)00422-1. PMID: 9426034.
- 3. Brugada J, Katritsis DG, et al; ESC Scientific Document Group. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Feb 1;41(5):655-720. doi: 10.1093/eurheartj/ehz467. Erratum in: Eur Heart J. 2020 Nov 21;41(44):4258. PMID: 31504425.
- 4. Helton MR. Diagnosis and Management of Common Types of Supraventricular Tachycardia. Am Fam Physician. 2015;92(9):793-800.
- 5. Peng G, Zei PC. Diagnosis and Management of Paroxysmal Supraventricular Tachycardia. JAMA. 2024;331(7):601-610. doi:10.1001/jama.2024.0076
- 6. Wegner FK, Habbel P, et al. Predictors of AVNRT Recurrence After Slow Pathway Modification. Int Heart J. 2021;62(1):72-77. doi:10.1536/ihj.20-463
- 7. Brembilla-Perrot B, Sellal JM, et al. Recurrences of symptoms after AV node re-entrant tachycardia ablation: a clinical arrhythmia risk score to assess putative underlying cause. Int J Cardiol. 2015;179:292-296. doi:10.1016/j.ijcard.2014.11.071
- 8. Halder A, Vijay S, et al. Clinical profile and electrophysiological characteristics of atypical atrioventricular nodal reentrant tachycardia: A decade's experience. Indian Pacing Electrophysiol J. 2024 Jan-Feb;24(1):25-29. doi: 10.1016/j.ipej.2023.10.004. Epub 2023 Oct 14. PMID: 37839730; PMCID: PMC10928009.
- 9. Marie Decroocq, Louis Rousselet, et al. Periprocedural, early, and long-term risks of pacemaker implantation after atrioventricular nodal re-entry tachycardia ablation: a French nationwide cohort, EP Europace, Volume 22, Issue 10, October 2020, Pages 1526–1536.
- 10. Liao JN, Hu YF, et al. Permanent pacemaker implantation for late atrioventricular block in patients receiving catheter ablation for atrioventricular nodal reentrant tachycardia. Am J Cardiol. 2013;111(4):569-573. doi:10.1016/j.amjcard.2012.11.003
- 11. Hanninen M, Yeung-Lai-Wah N, et al. Cryoablation versus RF ablation for AVNRT: A meta-analysis and systematic review. J Cardiovasc Electrophysiol. 2013;24(12):1354-1360. doi:10.1111/jce.12247
- 12. Zeljković I, Đula K, et al. High prevalence of hyperlipidaemia in patients with AV re-entry tachycardia and AV nodal re-entry tachycardia. Sci Rep. 2019 Aug 8;9(1):11502. doi: 10.1038/s41598-019-47940-9. PMID: 31395917; PMCID: PMC6687730.
- 13. Porter MJ, Morton JB, et al. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm. 2004;1(4):393-396. doi:10.1016/j.hrthm.2004.05.007
- 14. Aman Chugh, Fred Morady. Preexcitation, Atrioventricular Reentry, and Variants, Editor(s): Douglas P. Zipes, José Jalife, William G. Stevenson, Cardiac Electrophysiology: From Cell to Bedside (Seventh Edition), Elsevier, 2018, Pages 736-745, ISBN 9780323447331,https://doi.org/10.1016/B978-0-323-44733-1.00077-8.
- 15. O'Hara GE, Philippon F, et al. Catheter ablation for cardiac arrhythmias: a 14-year experience with 5330 consecutive patients at the Quebec Heart Institute, Laval Hospital [published correction appears in Can J Cardiol. 2009 Mar;25(3):140]. Can J Cardiol. 2007;23 Suppl B(Suppl B):67B-70B. doi:10.1016/s0828-282x(07)71013-9.
- 16. Bhaskaran A, Chik W, et al. A review of the safety aspects of radio frequency ablation. Int J Cardiol Heart Vasc. 2015;8:147-153. Published 2015 Jun 9. doi:10.1016/j.ijcha.2015.04.011
- 17. Fredrik Holmqvist, Milos Kesek, et al. A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes, European Heart Journal, Volume 40, Issue 10, 07 March 2019, Pages 820–830, https://doi.org/10.1093/eurheartj/ehy709
- 18. Kurt C. Roberts-Thomson, Peter M. Kistler, et al. Atrial Tachycardia: Mechanisms, Diagnosis, and Management. Current Problems in Cardiology, Volume 30, Issue 10, 2005, Pages 529-573, 7. ISSN 0146-2806, https://doi.org/10.1016/j.cpcardiol.2005.06.004..
- 19. Shehata M, Liu T, et al. Atrial tachycardia originating from the left coronary cusp near the aorto-mitral junction: anatomic considerations. Heart Rhythm. 2010;7(7):987-991. doi:10.1016/j.hrthm.2010.03.017.
- 20. Rosso R, Kistler PM. Focal atrial tachycardia. Heart. 2010;96(3):181-185. doi:10.1136/hrt.2008.143552
- 21. Gonzalez MD, Contreras LJ, Jongbloed MR, et al. Left atrial tachycardia originating from the mitral annulus-aorta junction. Circulation. 2004;110(20):3187-3192. doi:10.1161/01.CIR.0000147613.45259.D1
Details
| Primary Language | English |
|---|---|
| Subjects | Cardiovascular Medicine and Haematology (Other) |
| Journal Section | Araştırma Makalesi |
| Authors | |
| Project Number | 20.478.486/2350 |
| Publication Date | June 27, 2025 |
| Submission Date | December 9, 2024 |
| Acceptance Date | May 27, 2025 |
| Published in Issue | Year 2025 Volume: 12 Issue: 2 |
