Raharjo Sunu B, Togatorop Benny Tm, Andriantoro Hananto, Hanafy Dicky A, Yuniadi Yoga
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jl. Letjen S. Parman Kavling 87, Slipi, Jakarta, 11420, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jl. Letjen S. Parman Kavling 87, Slipi, Jakarta, 11420, Indonesia.
Indian Pacing Electrophysiol J. 2020 Jul-Aug;20(4):160-163. doi: 10.1016/j.ipej.2020.04.002. Epub 2020 Apr 8.
Ablating the slow pathway (SP) is the superior treatment for atrioventricular nodal reentrant tachycardia (AVNRT) with a low complication rate. However, the ablation of the SP could result in either complete elimination or modification of the SP. We aimed to investigate whether the duration of AH jump pre-ablation associated with the outcome of elimination of SP.
We included 56 patients with typical AVNRT (slow-fast), 20 males and 36 females, aged 44.2 ± 15.1 years. Slow pathway ablation was performed using classical approach. Univariate and multivariate analysis was performed for potential predictors of SP elimination.
Typical AVNRT was inducible in all patients. Post-ablation, non-inducibility of AVNRT was obtained in all 56 (100%) patients, with SP elimination in 33 (61%) patients and SP modification in 23 (39%) patients. Patients with SP elimination had significantly longer AH jump than patients with SP modification. Cox regression analysis showed that AH jump duration was the independent predictor of SP elimination, in which every 20 ms increase in AH jump duration was associated with 1.30 higher rate of SP elimination. Furthermore, ROC curve analysis indicated that the AH jump duration of ≥100 ms had 6.14 times higher probability for complete elimination of the SP with a sensitivity of 79%, specificity of 70%, PPV of 79% and NPV of 70%.
AH jump duration pre-ablation is associated with complete elimination of slow pathway during AVNRT ablation.
消融慢径路（SP）是房室结折返性心动过速（AVNRT）的首选治疗方法，并发症发生率低。然而，SP的消融可能导致SP完全消除或改变。我们旨在研究消融前AH间期跳跃的持续时间是否与SP消除的结果相关。
我们纳入了56例典型AVNRT（慢-快型）患者，其中男性20例，女性36例，年龄44.2±15.1岁。采用经典方法进行慢径路消融。对SP消除的潜在预测因素进行单因素和多因素分析。
所有患者均能诱发典型AVNRT。消融后，56例（100%）患者均未诱发AVNRT，其中33例（61%）患者的SP被消除，23例（39%）患者的SP被改变。SP被消除的患者的AH间期跳跃明显长于SP被改变的患者。Cox回归分析显示，AH间期跳跃持续时间是SP消除的独立预测因素，其中AH间期跳跃持续时间每增加20 ms，SP消除率就会提高1.30倍。此外，ROC曲线分析表明，AH间期跳跃持续时间≥100 ms时，SP完全消除的概率高出6.14倍，灵敏度为79%，特异度为70%，阳性预测值为79%，阴性预测值为70%。
消融前AH间期跳跃持续时间与AVNRT消融术中慢径路的完全消除相关。
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