Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Pharmacol Res Perspect. 2023 Apr;11(2):e01068. doi: 10.1002/prp2.1068.
We aimed to determine the effects of isoproterenol on arrhythmia recurrence in atrioventricular nodal re-entrant tachycardia (AVNRT) patients treated with catheter ablation. The present randomized controlled clinical trial was conducted on AVNRT patients candidates for radiofrequency ablation (RFA). The patients were randomly assigned to receive isoproterenol (0.5-4 μg/min) or not (control group) for arrhythmia re-induction after ablation. The results of the electrophysiological (EP) study, the ablation parameters, and the arrhythmia recurrence rate were recorded. We evaluated 206 patients (53 males and 153 females) with a mean (SD) age of 49.87 (15.5) years in two groups of isoproterenol (n = 103) and control (n = 103). No statistically significant difference was observed between the two studied groups in age, gender, EP study, and ablation parameters. The success rate of ablation was 100% in both groups. During ~16.5 months of follow-up, one patient (1%) in the isoproterenol group and four patients (3.8%) in the control group experienced AVNRT recurrence (HR = 0.245; 95% confidence interval [CI], 0.043-1.418; p = .173). Based on the Kaplan-Meier analysis, there was no significant difference in the incidence rate of arrhythmia recurrence during the follow-up period between the two studied groups (p = .129). Additionally, there were no significant differences between the arrhythmia's recurrence according to age, gender, junctional rhythm, type of AVNRT arrhythmia, and DAVN persistence after ablation. Although isoproterenol administration for arrhythmia re-induction after ablation did not alleviate the treatment outcomes and arrhythmia recurrence following RFA in AVNRT patients, further studies with a larger sample size and a longer duration of follow-up are necessary.
我们旨在确定异丙肾上腺素对接受导管消融治疗的房室结折返性心动过速（AVNRT）患者心律失常复发的影响。本随机对照临床试验对接受射频消融（RFA）的 AVNRT 患者进行。患者随机分为接受异丙肾上腺素（0.5-4μg/min）或不接受（对照组）心律失常再诱导。记录电生理（EP）研究结果、消融参数和心律失常复发率。我们评估了两组异丙肾上腺素（n=103）和对照组（n=103）中 206 名患者（53 名男性和 153 名女性）的平均（SD）年龄为 49.87（15.5）岁。在年龄、性别、EP 研究和消融参数方面，两组之间无统计学差异。两组消融成功率均为 100%。在~16.5 个月的随访期间，异丙肾上腺素组 1 例（1%）和对照组 4 例（3.8%）患者发生 AVNRT 复发（HR=0.245；95%置信区间 [CI]，0.043-1.418；p=0.173）。基于 Kaplan-Meier 分析，两组在随访期间心律失常复发率无显著差异（p=0.129）。此外，心律失常复发与年龄、性别、结性节律、AVNRT 心律失常类型和消融后 DAVN 持续时间无关。虽然 AVNRT 患者 RFA 后给予异丙肾上腺素进行心律失常再诱导并未减轻治疗结果和心律失常复发，但仍需要进一步的研究，以扩大样本量和延长随访时间。
