Slow pathway modification in patients presenting with only two consecutive AV nodal echo beats

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• 作者：Felix K. Wegner ; MS^a ; Maria Silvano ; MD^b ; Nils B&ouml ; geholz ; MD^a ; Patrick R. Leitz ; MD^a ; Gerrit Frommeyer ; MD^a ; Dirk G. Dechering ; MD^a ; Stephan Zellerhoff ; MD^a ; Simon Kochh&auml ; user ; MD^a ; Philipp S. Lange ; MD^a ; Julia K&ouml ; be ; MD^a ; Kristina Wasmer ; MD^a ; Gerold M&ouml ; nnig ; MD^a ; Lars Eckardt ; MD^a ; Christian Pott ; MD^a ; ^{christian.pott@ukmuenster.de}
• 关键词：Empirical slow pathway modification ; AV-nodal reentry tachycardia ; Electrophysiology ; Supraventricular tachycardia ; AV node
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：69
• 期：2
• 页码：471-475
• 全文大小：448 K
• 卷排序：69

文摘

Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown.MethodsOut of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs.ResultspSVT documentation by electrocardiography (ECG) was present in 20 patients. The procedural endpoint was inducibility of less than two AVNEBs. This was reached in 31 (97%) patients. Long-term success was assessed by a telephone questionnaire (follow-up time 63 ± 9 months). A total 94% of the patients benefited from the procedure (59% freedom from symptoms; 34% improvement in symptoms). Among those patients in whom ECG documentation was not present, 100% benefited (58% freedom from symptoms, 42% improvement).ConclusionThis is the first collective analysis of a group of patients presenting with symptoms of pSVT and inducibility of only two AVNEBs. Procedural success and clinical long-term follow-up were in the range of the reported success rates of slow pathway modification of inducible AVNRT, independent of whether ECG documentation was present. Thus, SPM is a safe and effective therapy in patients with two AVNEBs.