Cateheter ablation treatment of atrioventricular nodal re-entrant tachycardia

Yıl 2012, Cilt: 39 Sayı: 2, 166 - 173, 01.06.2012

İbrahim Halil Tanboğa Mustafa Kurt Turgay Işık Ahmet Kaya Enbiya Aksakal Mehmet Ekinci Eftal Murat Bakırcı Hasan Kaya Serdar Sevimli

https://doi.org/10.5798/diclemedj.0921.2012.02.0121

Cited By: 1

Öz

Objectives: In this study, we aimed to evaluate our clinical experience about the catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) including complications and long-term outcomes. Materials and Methods: The study population consisted of 166 patients with AVNRT, 52 of whom from hospital-1 and 114 of who from hospital-2. Radio-frequency (RF) ablation therapy was applied after the basic electrophysiology study. Complications in RF ablation and long-term recurrences were noted. Results: More than 90% of the patients had symptoms persisting for more than one year and again more than 90% of those were suffering at least 2 episodes per month. The success rate of RF ablation was 98.2% for the entire study population. The recurrence rate was observed to be 3% (n=5) throughout the follow-up period. In the multivariate Cox regression analysis; young age, operator`s experience (Hospital 1 vs. 2), and presence of atypical AVNRT were the independent predictors of long-term recurrence. Major complications related to AVNRT ablation are not encountered frequently. Death, myocardial infarction and stroke were not seen in any of the patients, however, two patients developed deep vein thrombosis. Minor complications in RF ablation included asymptomatic minimal/mild pericardial effusion (n=5), femoral hematoma requiring no transfusion (n=5) and transient AV block (n=5). Atrio-ventricular block requiring permanent pacemaker implantation was found only in one patient (0.6%). Conclusion: Radio-frequency catheter ablation in patients with AVNRT appears to be a safe and effective method. The presence of atypical AVNRT, young age and operator`s experience were observed to be the independent predictors of long-term recurrence.

Anahtar Kelimeler

Atrioventricular nodal reentrant tachycardia, radio-frequency ablation, recurrence, complication.

Cateheter ablation treatment of atrioventricular nodal re-entrant tachycardia

Öz

Amaç: Atriyoventriküler nodal re-entrant taşikardilerin (AVNRT) radyo-frekans (RF) ablasyon tedavisi ile ilgili olarak klinik deneyimimizi, gözlenen komplikasyonları ve uzun dönem sonuçları kapsamlı bir şekilde değerlendirmeyi amaçladık. Gereç ve yöntem: Çalışmaya Hastane-1 (n=52) ve Hastane-2`de (n=114) olmak üzere toplam 166 AVNRT hastası alınmıştır. Bu hastalara temel elektrofizyolojiden sonra RF ablasyon tedavisi uygulanmıştır. işlem esnasında gözlenen komplikasyonlar ve uzun dönem takipte gelişen tekrarlamalar kaydedilmiştir. Bulgular: Çalışmaya alınan hastaların >%90 da semptomlar bir yıldan fazla devam etmekteydi ve en az 2 atak yaşamaktaydı. Tüm grup için RF ablasyon başarı oranı %98,2 idi. Tüm popülasyon için rekürrens oranı % 3 (5 hasta) idi. AVNRT ablasyonu sonrası uzun dönem takipte rekürrens prediktorleri olarak yaş, operatör deneyimi (hastane 1 ve 2) ve atipik AVNRT varlığı olarak bulundu. AVNRT ablasyonu ile ilişkili majör komplikasyon oranı oldukça düşük olup sadece 2 hastada derin ven trombozu izlenirken, hiç bir hastada ölüm, miyokard enfarktüsü, inme veya kardiyak tamponad izlenmedi. Minor komplikasyonlardan asemptomatik minimal-hafif perikardiyal efüzyon 5 hastada, kasık yerinde transfüzyon gerektirmeyen hematom (5 hasta) ve geçici AV blok (5 hasta) olarak tespit edildi. Sadece 1 hastada (% 0. 6) kalıcı pil implantasyonu gerektiren AV blok izlendi. Sonuç: AVNRT nin RF ablasyonu hem akut dönemde hemde uzun dönem takipte güvenli ve etkili bir yöntemdir. Atipik AVNRT varlığı, genç yaş ve operatör deneyimi uzun dönem rekürrens için esas belirleyicilerdir.

Anahtar Kelimeler

Atriyoventriküler nodal re-entrant taşikardi, Radyofrekans ablasyon, rekürrens, komplikasyon

Kaynakça

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