Radyofrekans ablasyon uygulanmış hastalarda artmış yüksek-duyarlıklı kardiyak troponin seviyesinin değerlendirilmesi

Year 2018, , 23 - 26, 15.02.2018

Yahya Kemal İçen , Mevlüt Koç

https://doi.org/10.28982/josam.384057

Abstract

Amaç: Çalışmamızda; radyofrekans ablasyon (RFA) uygulanan hastalarda ablasyon parametreleri ile yüksek duyarlıklı troponin testi (hs-cTnT) düzeyinin ilişkisini araştırdık.

Gereç ve Yöntem: Bir yıl önce RFA yapılan ve daha sonra göğüs ağrısı ile acil servise başvuran hastaları çalışmamıza dahil ettik. EKG ve ekokardiyografik inceleme tüm hastalar için elektrofizyolojik çalışma (EPS) öncesinde yapıldı. RFA'dan sonra toplam süre, enerji ve ortalama sıcaklık ile ilgili bilgiler kaydedildi. Acil servise göğüs ağrısı ile başvuran RFA uygulanmış hastalardan kan örnekleri venöz yolla alındı

Bulgular: Çalışmamıza 119 hasta [38 erkek, medyan 51 yaş (IQR: 29)] alındı. Bunların 6'sında (%80,7) atriyoventriküler nodal re-entran taşikardi (AVNRT), 14'ü (%11,8) Wolff Parkinson White Sendromu (WPW) ve 9'u (%7,5) Sağ Ventrikül Çıkıntı Yolu (RVOT) Taşikardisi tespit edildi. Hs-cTnT ve toplam RFA süresi (r=0,683, p<0.001), toplam enerji (r=0,423, p<0,001) ve ortalama sıcaklık (r=0,371, p<0,001) korele bulundu. Doğrusal regresyon analizinde; toplam RFA süresi (OR: 0,842, %95 GA: 0,685-0,999, p<0.001) ve ortalama sıcaklık (OR: 10,738, %95 GA: 6,420-15,055, p<0,001), hs-cTnT için bağımsız ön gördürücü olarak saptandı.

Sonuç: Bu çalışma bize, RFA uygulanan uzun süreli ve yüksek sıcaklıktaki hastaların göğüs ağrısı ile acil servise başvurabileceğini, bu nedenle troponin düzeylerinin artabileceğini ve bu hastalarda daha ileri tedavi veya takip gerekmeyeceğini göstermiştir.

Keywords

Yüksek duyarlıklı troponin, Radyofrekans ablasyon, Acil servis

Evaluation of increased high-sensitivity cardiac troponin in patients with radiofrequency ablation

Abstract

Aim: In our study; we explored which ablation parameter is mostly associated with the increased high-sensitivity troponin tests (hs-cTnT) in patients undergone radiofrequency ablation (RFA).

Methods: We included patients who underwent RFA within the previous year, and later admitted to emergency service with chest pain to our study. ECG and echocardiographic examination were performed before the electrophysiological study (EPS) for all patients. After RFA, information regarding the total duration, energy and mean temperature was recorded. Blood samples were collected via venous route from patients who underwent RFA, and later admitted to emergency service with chest pain to study hs-cTnT.

Results: There were 119 patients [38 males, median age 51years (IQR:29)] included in our study. 6 of them (80.7%) were detected to have atrioventricular nodal re-entrant tachycardia (AVNRT), 14(11.8%) Wolff Parkinson White Syndrome (WPW), and 9 (7.5%) Right Ventricular Outflow Tract (RVOT) Tachycardia. Hs-cTnT and total RFA duration (r=0.683,p<0.001), total energy (r=0.423, p<0.001) and mean temperature (r=0.371, p<0.001) were correlated. In linear regression analysis; total RFA duration (OR:0.842, 95% CI: 0.685-0.999, p<0.001) and mean temperature (OR:10.738, 95% CI: 6.420-15.055, p<0.001) were detected to be independent predictors for hs-cTnT. 

Conclusion: This study has shown us that it should be noted that patients who underwent RFA for a prolonged duration and at high temperature may admit to the emergency service with chest pain, therefore, their troponin levels may increase, and also in these patients no further work-up or treatment would be required.

Keywords

High-sensitivity troponin, Radiofrequency ablation, Emergency service

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