Paroksismal Supraventriküler Taşikardide Tek Merkez Radyofrekans Ablasyon Deneyimi

Öz

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.

Anahtar Kelimeler

• Paroksismal supraventriküler taşikardi
• radyofrekans ablasyon
• kardiyak elektrofizyoloji
• atriyoventriküler nodal reentran taşikardi
• atriyoventriküler reentran taşikardi
• atriyal taşikardi.

Single Center Radiofrequency Ablation Experience In Paroxysmal Supraventricular Tachycardias

Öz

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.

Anahtar Kelimeler

• Paroxysmal supraventricular tachycardia
• radiofrequency ablation
• cardiac electrophysiology
• atrioventricular nodal reentrant tachycardia
• atrioventricular reentrant tachycardia
• atrial tachycardia.

Kaynakça

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