Clinical characteristics of the patients presented with supraventricular tachycardia in southeast Anatolian region of Turkey

Öz

Objective: In this study, we aimed to evaluate the characteristic of patients with supraventricular tachycardia for proper diagnosis and treatment in Southeast Anatolian region. Methods: The study was has a retrospective cross-sectional design. One hundred eighty-seven consecutive patients who underwent catheter ablation of SVT between June 2012 and April 2014 at the Dicle University Heart Hospital were included in the study. In those patients, in whom the arrhythmia substrate was identified, ablation therapy was carried out using radiofrequency (RF) energy. Results: Among SVTs 119 (63.6%) patients had atrioventricular nodal re-entry tachycardia (AVNRT), 20 (10.7%) patients had concealed atrioventricular re-entry tachycardia (AVRT), 40 (21.4%) patients had Wolf Parkinson White (WPW) syndrome, and 8 (4.3%) patients had atrial tachycardia. RF ablation was applied on 184 patients. Overall RF ablation success rate was 96.2%. Overall recurrence was 8 (4%) of 187 patients during the follow-up period 12 ± 6 (1-23) months. The recurrence was 4 (3.4%) of 119 patients in AVNRT, 2(5%) of 40 patients in WPW syndrome and 2 (10%) of 20 patients in concealed AVRT. There was no statistically significant difference between groups in terms of recurrence. Two patients having AVNRT ablation died due to acute coronary syndrome in clinical follow-up. Conclusion: The acute and long-term success rates of SVT ablation were in accordance with literature. The other characteristics of SVT were similar with the current data.

Anahtar Kelimeler

• Supraventricular tachycardia, radiofrequency energy, ablation

Güneydoğu Anadolu Bölgesinde supraventriküler taşikardi ile başvuran hastaların klinik özellikleri

Öz

Amaç: Bu çalışmamızın amacı Güneydoğu Anadolu bölgesinde supraventriküler taşikardilerin (SVT) tanı ve tedavisinin klinik özelliklerinin değerlendirilmesidir. Yöntemler: Çalışma retrospektif olarak yapıldı. Haziran 2012 ve Nisan 2014 süresinde, Dicle Üniversitesi Kalp Hastanesinde ablasyon tedavisi amacıyla kateter ablasyon laboratuarına alınan ardışık 187 hasta çalışmaya dahil edildi. Aritmi ayırıcı tanısı yapıldıktan sonra aritmi odağı radyofrekans (RF) yöntemi ile ablasyon yapıldı. Bulgular: Supraventriküler taşikardili hastaların 119\'u (%63,6) atriyoventriküler (AV) nodal reentran taşikardi (AVNRT), 20\'si (%10,7) gizli AV reentran taşikardi (AVRT), 40\'ı (%21,4) Wolf-Parkinson-White (WPW) sendromu ve 8\' i (%4,3) atriyal taşikardi olarak saptandı. Yüz seksen dört hastaya RF ablasyon tedavisi uygulandı. Genel olarak RF ablasyon başarısı % 96,2 idi. Genel olarak 12 ± 6 (1-23 ay) aylık sürede 8 (%4) hastada nüks gelişti. Nüks gelişen hastaların 4 (%3,4)\'ü AVNRT, 2 (%5)\'si WPW sendromu ve 2 (%10)\' si gizli AVRT olduğu saptandı. Gruplar arasında nüks açısından istatiksel olarak fark yoktu. Takiplerde AVNRT ablasyonu yapılmış olan 2 hasta akut koroner sendrom nedeniyle öldüğü saptandı. Sonuç: Supraventriküler taşikardili hastaların özellikleri literatür bilgileri ile benzerlik göstermektedir ve kliniğimizde SVT hastalarının tanı ve tedavisi literatür ile uyumlu olarak başarılı bir şekilde yapılmaktadır.

Anahtar Kelimeler

• Supraventriküler taşikardi, radyofrekans enerji, ablasyon

Kaynakça

1. Walfridsson U, Strömberg A, Janzon M, Walfridsson H. Wolff-Parkinson-White syndrome and atrioventricular nodal re-entry tachycardia in a Swedish population: conse- quences on health-related quality of life. Pacing Clin Elec- trophysiol 2009;32:1299-1306.
2. Porter MJ, Morton JB, Denman R, et al. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm 2004;1:393-396.
3. Tada H, Oral H, Greenstein R, et al. Analysis of age of on- set of accessory pathway-mediated tachycardia in men and women. Am J Cardiol 2002;89:470-471.
4. Delacretaz E. Supraventricular tachycardia. N Engl J Med 2006;354:1039-1051.
5. Gursoy S, Steurer G, Brugada J, et al. The hemodynamic mechanism of pounding in the neck in atrioventricular nod- al reentrant tachycardia. N Engl J Med 1992;327:772-774.
6. Bathina MN, Mickelsen S, Brooks C, et al. Radiofrequency catheter ablation versus medical therapy for initial treatment of supraventricular tachycardia and its impact on quality of life and healthcare costs. Am J Cardiol 1998;82:589-593.
7. Goldberg AS, Bathina MN, Mickelsen S, et al. Long-term outcomes on quality-of-life and health care costs in pa- tients with supraventricular tachycardia (radiofrequency catheter ablation versus medical therapy). Am J Cardiol 2002;89:1120-1123.
8. Tanboğa IH, Kurt M, Işık T, et al. Catheter ablation treatment of atrioventricular nodal re-entrant tachycardia. Dicle Med J 2012;39:166-173.

9. Obeyesekere MN, Leong-Sit P, Massel D, et al. Risk of ar- rhythmia and sudden death in patients with asymptomatic preexcitation: a meta-analysis. Circulation 2012;125:2308- 2315.
10. Klein GJ, Bashore TM, Sellers TD, et al. Ventricular-fibril- lation in the Wolff-Parkinson-White Syndrome. N Engl J Med 1979;301:1080-1085.
11. Winniford MD, Fulton KL, Hillis LD. Long-term therapy of paroxysmal supraventricular tachycardia: a randomized, double-blind comparison of digoxin, propranolol and vera- pamil. Am J Cardiol 1984;54:1138-1139.
12. Feldman A, Voskoboinik A, Kumar S, et al. Predictors of acute and long-term success of slow pathway ablation for atrioventricular nodal reentrant tachycardia: a single center series of 1,419 consecutive patients. Pacing Clin Electro- physiol 2011;34:927-933.
13. Stern JD, Rolnitzky L, Goldberg JD, et al. Meta-analysis to assess the appropriate endpoint for slow pathway ablation of atrioventricular nodal reentrant tachycardia. Pacing Clin Electrophysiol 2011;34:269-277.
14. Scheinman MM, Huang S. The 1998 NASPE prospec- tive catheter ablation registry. Pacing Clin Electrophysiol 2000;23:1020-1028.
15. Ganz LI, Friedman PL. Supraventricular tachycardia. N Engl J Med 1995;332:162-173.
16. Calkins H, Yong P, Miller JM, et al. Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachy- cardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multi- center Investigators Group. Circulation 1999;99:262-270.
17. Friedman PL, Dubuc M, Green MS, et al. Catheter cryoab- lation of supraventricular tachycardia: results of the multi- center prospective “frosty” trial. Heart Rhythm 2004;1:129- 138.
18. Kay GN, Epstein AE, Dailey SM, Plumb VJ. Role of radio- frequency ablation in the management of supraventricular arrhythmias: experience in 760 consecutive patients. J Car- diovasc Electrophysiol 1993;4:371-389.
19. Biviano AB, Bain W, Whang W, et al. Focal left atrial tachy- cardias not associated with prior catheter ablation for atrial fibrillation: clinical and electrophysiological characteris- tics. Pacing Clin Electrophysiol 2012;35:17-27.
20. Lesh MD, van Hare GF, Epstein LM, et al. Radiofrequency catheter ablation of atrial arrhythmias. Results and mecha- nisms. Circulation 1994;89:1074-1089.