Result of electrophysiological study in patients with undocumented suspected paroxysmal supraventricular tachycardia: the BELIEVE-SVT registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Ramos Jimenez ◽  
A Marco Del Castillo ◽  
VC Lozano Granero ◽  
P Ramos Fernandez ◽  
D Jimenez Sanchez ◽  
...  
Keyword(s):  
Electrophysiological Study ◽  
Sudden Onset ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Funding Sources ◽  
Painful Site ◽  
First Choice ◽  
Study Results ◽  
Pr Interval ◽  
Supraventricular Tachycardias

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Paroxysmal supraventricular tachycardias (PSVT) are common arrhythmias and catheter ablation is considered its first-line treatment. However, the duration of the episodes frequently precludes ECG documentation. Thus, patients may not be referred for ablation until the tachycardia is documented, leading to recurrences, emergency room visits and often unnecessary tests or treatments. Our objective was to evaluate the results of electrophysiological study (EPS) followed or not by ablation in patients with suspected but not documented PSVT. Methods Multicenter, retrospective, observational registry of consecutive patients undergoing EPS due to clinical suspicion of PSVT, but with no prior ECG documentation. Collection of clinical and EPS data, along with data regarding ablation, when performed. Results 427 patients of 12 centers were included. Mean age was 46.3 ±16.1 and 297 (69.6%) were females. Most frequent symptoms consisted on sudden onset (n = 360; 84.9%) and abrupt end (n = 304; 72.0%), with median episode duration of 10 minutes (interquartile range 5-20 min). Sustained arrhythmias were induced in most patients (n = 255; 59.7%). Specific types are summarized in Table 1. Ablation was performed in 274 (64.2%) patients. A total of 10 complications (2.3% of procedures) were reported: 3 transient AV block, 2 PR interval prolongation, 2 puncture-related hematoma, 2 painful site of puncture and 1 catheter entrapment in mitral chordae. Conclusions Electrophysiological study in patients with palpitations highly suggestive of PSVT is an effective and safe diagnostic and therapeutic tool that may be considered as a first-choice even in the absence of documented tachycardia. Results of EP study Results of electrophysiological study Typical AVNRT 183 (42.9%) Orthodromic AVRT 38 (8.9%) Dual AV nodal physiology 30 (7.0%) 1 nodal echo beat 21 (4.9%) Atrial tachycardia 19 (4.5%) >1 nodal echo beat 17 (4.0%) Atrial fibrillation 7 (1.6%) Atypical AVNRT 7 (1.6%) Atrial flutter 1 (0.2%) No abnormal findings 104 (24.4%) AVNRT atrioventricular nodal reentran tachycardia AVRT atrioventricular reentrant tachycardia

scholarly journals Recurrence of palpitations following electrophysiological study and ablation in suspected but undocumented paroxysmal supraventricular tachycardias: follow-up results of the BELIEVE-SVT registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Marco Del Castillo ◽  
J Ramos Jimenez ◽  
VC Lozano Granero ◽  
M Rodriguez Manero ◽  
P Ramos Fernandez ◽  
...  
Keyword(s):  
Electrophysiological Study ◽  
Clinical Suspicion ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Early Referral ◽  
Clinical Recurrence ◽  
Funding Sources ◽  
High Clinical Suspicion ◽  
Pr Interval ◽  
Supraventricular Tachycardias

Abstract Funding Acknowledgements Type of funding sources: None. Introduction ECG documentation of paroxysmal supraventricular tachycardias (PSVT) may be challenging due to their short duration and usually abrupt end.  As ablation represents first-line treatment of this pathologies, it is not uncommon that physicians refer patients to electrophysiological study (EPS) when symptoms are suggestive of PSVT even though no ECG documentation has been obtained. Our objective was to evaluate the results of ablation performed in patients with induced arrhythmias in EPS but no previous ECG documentation. Methods Retrospective and observational multicenter registry of consecutive patients undergoing EPS, followed or not by ablation, referred because of undocumented clinical suspicion of PSVT. We collected clinical, EPS and clinical follow-up data, along with data regarding ablation, when performed. Descriptive statistical analysis was carried out using Stata. Results 427 patients of 12 centers were included. Mean age was 46.3 ± 16.1 and 297 (69.6%) were females. Sustained arrhythmias were induced in most patients (n = 255; 59.7%) and ablation was performed in 274 (64.2%). 10 complications (2.3% of procedures) were reported: 3 transient AV block, 2 PR interval prolongation, 2 puncture-related hematoma, 2 painful sites of puncture and 1 catheter entrapment in mitral chordae. During a mean follow-up of 3.1 ± 2.0 years, 111 patients experienced recurrence of palpitations, mostly (n = 77; 69.4%) without ECG documentation. Clinical recurrence was more frequent in subjects who had not been ablated (41.8% vs 17.2% in ablated patients; risk ratio 2.44 (CI 95% 1.77-3.36); p < 0.001). Table 1 shows types of clinical recurrences. Conclusions EPS in patients with high clinical suspicion of PSVT, followed by ablation when tachycardia is induced is effective in preventing future recurrences of palpitations. Early referral for EPS can, therefore, reduce visits to the emergency room, admissions and healthcare burden due to other low-yield, unnecessary tests. Type of recurrence ECG documentation 34(8.0%) ·Sinus rhythm 12(2.8%) ·Atrial tachycardia 6(1.4%) ·Typical atrioventricular nodal reentrant tachycardia 5(1.2%) ·Atrial fibrillation 5(1.2%) ·Premature ventricular beats 3(0.7%) ·Orthodromic atriventricular tachycardia 2(0.5%) Non documented recurrence 77(18.0%)

scholarly journals Implantable loop recorder: experience of a center

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Marques Pires ◽  
P Medeiros ◽  
C Oliveira ◽  
I Campos ◽  
M Flores ◽  
...  
Keyword(s):  
Positive Impact ◽  
Blood Pressure Monitoring ◽  
Electrophysiological Study ◽  
Stress Test ◽  
Sinus Node ◽  
Oral Anticoagulants ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Implantable Loop Recorder ◽  
Diagnostic Challenge ◽  
Loop Recorder

Abstract Funding Acknowledgements Type of funding sources: None. INTRODUCTION Symptoms like syncope and palpitations are frequent and represent a diagnostic challenge. The implantable loop recorder (LR) is an important diagnostic tool, in selected cases. AIM To describe the main implantation indications of LR and to evaluate the diagnostic findings and therapeutic interventions. METHODS A retrospective study of patients (pts) that underwent LR implantation in our hospital from 2014 to 2019. For each pt the indication for implantation, baseline characteristics, previous study, recorded tracing and interventions were evaluated. RESULTS A total of 52 pts were included, 56% women, with a mean age of 60 years old. The implantation indications were recurrent syncope/ presyncope in 47 pts (90%) and palpitations in 5 pts (10%). All pts had a baseline echocardiogram and electrocardiogram, with 90% in sinus rhythm. QRS complex and atrial-ventricular conduction was normal in 50% of the pts. Previous to LR implantation, 46 pts (89%) had performed Holter, 19 (37%) carotid sinus massage, 14 (27%) Tilt table test, 29 (56%) stress test, 11(21%) ambulatory blood pressure monitoring and 9 (17%) electrophysiological study. During the monitoring period, 27 pts (52%) had recurrence of the symptoms. In this subgroup, we observed that 67% had a rhythmic cause capable of justified the symptoms, with a median of 5 months since implantation until diagnosis. In addition, the LR was useful in ruling out a rhythmic cause for symptoms in 33% of the cases. In the 47 pts with syncope/presyncope: 6(13%) had sinus node dysfunction, 4 (9%) had atrioventricular conduction disturbance, 1(2%) had atrial fibrillation (AF) and 3 (6%) had ventricular dysrhythmias. In the 5 pts with palpitations: 1(20%) had AF ad 3 (60%) had paroxysmal supraventricular tachycardia. LR results led to cardiac device implantation in 13 pts (pacemaker-9, implantable cardioverter desfibrillator-4). In addition, 2 pts are waiting for electrophysiological study and eventual ablation and 3 pts initiated antiarrhythmic therapy, and those with new diagnosis of AF also initiated oral anticoagulants. CONCLUSION In this study, the implantation of LR was useful to clarify the cause of the symptomology in 52% of the pts. In 35% of pts with symptom-rhythm correlation it ensured timely introduction of therapeutic approach with a positive impact on life quality.

scholarly journals 251 Delay between initial electrophysiological study and ablation of the tachycardia in patients with paroxysmal supraventricular tachycardia

2012 ◽  
Vol 4 (1) ◽  
pp. 79
Author(s):  
Béatrice Brembilla-Perrot ◽  
Jean Marc Sellal ◽  
Pierre Yves Zinzius ◽  
Jérôme Schwartz ◽  
Daniel Beurrier ◽  
...  
Keyword(s):  
Supraventricular Tachycardia ◽  
Electrophysiological Study ◽  
Paroxysmal Supraventricular Tachycardia

SUPRAVENTRICULAR TACHYCARDIA WOLFF-PARKINSON-WHITE SYNDROME IN CHILDREN OF THE REPUBLIC OF BELARUS: AGE AND SEX CHARACTERISTICS, IDENTIFICATION, ELECTROPHYSIOLOGICAL STRUCTURE

2021 ◽  
pp. 110-113
Author(s):  
Strogiy V.V. ◽  
◽  
Zasim E.V. ◽  
Drozdovsky K.V. ◽  
Kadochkin V.O. ◽  
...  
Keyword(s):  
Neonatal Period ◽  
Electrophysiological Study ◽  
Conduction System ◽  
Sex Characteristics ◽  
First Year ◽  
Depth Study ◽  
The Republic ◽  
First Year Of Life ◽  
Supraventricular Tachycardias ◽  
Wolff Parkinson White Syndrome

The goal is to establish the frequency of supraventricular tachycardias in children of the Republic of Belarus, to determine the structure and characteristics of these rhythm disturbances. An in-depth study of the properties of the conduction system of the heart was carried out by performing in the course of the esophageal electrophysiological study 108 children. A more rare detection of SVT in children in the neonatal period, in the first year of life and maximum detection at the age of 17 years, a comparatively rare finding (11.8 %) of concomitant pathology in children with SVT.

scholarly journals Safety and efficacy of electrophysiological studies and radiofrequency ablation of paroxysmal supraventricular tachycardia

2020 ◽  
Vol 4 (3) ◽  
pp. 818-821
Author(s):  
Abdul Khaliq Monib ◽  
Rajesh Nepal ◽  
Sahadeb Prasad Dhungana ◽  
Roshan Raut
Keyword(s):  
Radiofrequency Ablation ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Study Data ◽  
Female Dominance ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Safety And Efficacy ◽  
Efficacy Analysis ◽  
Early Results ◽  
Reentry Tachycardia

Introduction: Cardiac electrophysiological study (EPS) and radiofrequency ablation (RFA) is an established mode of treatment either as first-line or for drug-refractory arrhythmias. Our center has recently started this service under 2-D mapping outside Kathmandu valley Objective: The aim was to evaluate the safety and efficacy of EPS and RFA for paroxysmal supraventricular tachycardias (PSVT). Methodology: This is an observational prospective study carried out in the Cardiac Unit of Nobel medical college, Biratnagar, Nepal. All cases diagnosed to have PSVT based on electrocardiogram or Holter recordingfromAugust 2018 and May2019wereincluded in the study. Data on clinical profile and findings of EPS were recorded. Fifty-nine cases were chosen for safety and efficacy analysis, using SPSS statistical software version 19. Results: There were 59 patients, 28(47.5%) males, and 31(52.5%) females. The mean age was 38.2 ± 15.9 years. Fifty-three patients underwent RFA while 6 patients underwent only EPS. In the Atrioventricular nodal reentry tachycardia (AVNRT) group, there was female dominance (P=0.2) while in Atrioventricular reentry tachycardia (AVRT) group, there was no significant gender difference (p=0.4). Left-sided pathway (68%) was more common in the AVRT group. Among the left accessory pathway (AP), left lateral AP (44%) was more common. No major complications including death were noted. Two cases of successful ablation relapsed in one month follow up. Conclusions: Early results of this small study in patients with PSVT confirm the efficacy and safety of RFA in newly established electrophysiology (EP) laboratory.

Results of electrophysiological study and ablation in patients with syncope and paroxysmal supraventricular tachycardia

2007 ◽  
Vol 40 (4) ◽  
pp. S8
Author(s):  
Basri Amasyali ◽  
Sedat Köse ◽  
Hurkan Kursaklioglu ◽  
Turgay Celik ◽  
Atila İyisoy ◽  
...  
Keyword(s):  
Supraventricular Tachycardia ◽  
Electrophysiological Study ◽  
Paroxysmal Supraventricular Tachycardia

Tracheobronchial foreign body aspiration in children: a 5-year retrospective study from Shanghai, China

2019 ◽  
Author(s):  
Guodong Ding ◽  
Beirong Wu ◽  
Angela Vinturache ◽  
Chen Cai ◽  
Min Lu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Descriptive Analysis ◽  
Sudden Onset ◽  
Rigid Bronchoscopy ◽  
Flexible Bronchoscopy ◽  
Older Children ◽  
Female Ratio ◽  
X Ray ◽  
Presenting Symptoms ◽  
First Choice

Abstract Background Foreign body (FB) aspiration is a common and serious problem in childhood, but little information is available about this condition in Chinese context. We aimed to characterize the clinical and epidemiological features of airway FBs in a pediatric Chinese population. Methods A retrospective review of medical records of children aged 0-14 years who attended with a diagnosis of FB aspiration the Shanghai Children's Hospital between 2013 and 2017 was carried out. Descriptive analysis was used to assess patient's demographics, clinical, radiographic, bronchoscopic findings, time to presentation, and characteristics of the FBs. Results Among the 200 patients included in the study, 92% were under 3 years of age, with a peak incidence of FB aspiration occurring between 1 and 2 years. The male to female ratio was 2.6:1. Twenty-three percent of the patients were admitted within 24 hours of the event, 40% within 1 week, 30% within 1 month, and 7% more than 1 month after aspiration. Eleven percent were laryngotracheal FBs and 89% were bronchial FBs. The most common presenting symptoms of laryngotracheal FBs were cough, dyspnea, and wheezing; those of bronchial FBs were cough, decreased air entry, and wheezing. Chest X-ray was normal in four-fifths of the children with laryngotracheal FBs, whereas most common abnormal x-ray findings in children with bronchial FBs were mediastinal shift, obstructive emphysema, and pneumonia. In children younger than 2 years FBs were more frequently found in the left bronchus, whereas in older children FBs were more frequently found in the right bronchus. Ninety-three percent of the removed FBs were organic materials such as food items and the most frequently aspirated FBs were peanuts. Flexible bronchoscopy was successfully performed in 80.5% of the patients, while rigid bronchoscopy or direct laryngoscopy in 17.5% of the patients. Four patients were subjected to thoracic surgery and 1 died during bronchoscopy due to acute respiratory failure. Conclusions Tracheobronchial FBs should be suspected in children who have sudden onset of cough and wheezing episode, even when physical and radiographic evidence is absent. Flexible bronchoscopy has become the first choice in China used for FB removal from airways in children.

Supraventricular Tachycardia

2020 ◽  
Author(s):  
Laurence M. Epstein ◽  
Saurabh Kumar
Keyword(s):  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Tissue ◽  
Accessory Pathway ◽  
Maze Procedure ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Inappropriate Sinus Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Supraventricular Tachycardias

Supraventricular tachycardias (SVTs) comprise a group of usually benign arrhythmias that originate from cardiac tissue at or above the His bundle. SVTs include inappropriate sinus tachycardia, atrial tachycardias (ATs), atrial flutter (AFL), junctional tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and forms of accessory pathway–mediated reentrant tachycardias (atrioventricular reentrant tachycardia [AVRT]). Although mostly benign, symptoms can be debilitating, in the form of palpitations, shortness of breath, chest discomfort, dizziness, and/or syncope; rarely, SVTs can result in cardiomyopathy due to incessant arrhythmia. This review covers the epidemiology, diagnosis, management, and classification of SVTs.  This review contains 14 figures, 17 tables, and 61 references. Keywords: Supraventricular tachycardia, cardioversion, arrhythmia, atrial flutter, atrial fibrillation, Wolff-Parkinson-White syndrome, MAZE procedure, catheter ablation

Concealed accessory pathways and related tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2091-2092
Author(s):  
Carlo Pappone ◽  
Vincenzo Santinelli
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Node ◽  
Tricuspid Annulus ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways ◽  
Purkinje System ◽  
Electrical Impulses ◽  
Supraventricular Tachycardias ◽  
Retrograde Conduction

Conduction from the atria to the ventricles normally occurs via the atrioventricular node–His–Purkinje system. Accessory pathways (APs) directly connect the atrium and ventricle and bypass the atrioventricular node, bridging the mitral or, less commonly, the tricuspid annulus. Concealed APs conduct electrical impulses retrogradely from the ventricles to the atria, but not antegradely from the atria to the ventricles. Approximately 40% of all APs are concealed, and orthodromic atrioventricular reentrant tachycardia due to concealed APs is present in up to 15% of patients with supraventricular tachycardias referred for catheter ablation. Most concealed APs are left-sided, exhibiting non-decremental retrograde conduction. Tachyarrhythmias due to concealed APs are managed similarly to those supraventricular tachycardias associated with manifest APs, and symptomatic tachyarrhythmias are successfully treated by radiofrequency catheter ablation in the majority of patients.

scholarly journals Cardiac Electrophysiological Study & Radiofrequency Ablation: Our Experience in Nepal

1970 ◽  
Vol 1 (1) ◽  
pp. 4-7
Author(s):  
Sujeeb Rajbhandari ◽  
Man Bdr KC ◽  
Roshan Raut ◽  
Murari Dhungana ◽  
Rajesh Shaha ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Radiofrequency Ablation ◽  
Success Rate ◽  
Complication Rate ◽  
Cardiac Arrhythmias ◽  
Electrophysiological Study ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Radiofrequency Energy ◽  
Supraventricular Arrhythmias ◽  
Cardiac Intervention

Background and aim - Cardiac Electrophysiological Study and Radiofrequency ablation is a form of cardiac intervention for diagnosing and treating cardiac arrhythmias. Various catheters are placed in the various parts of the heart to record signals and radiofrequency energy is used for the ablation. Methods - A total of 768 patients with paroxysmal supraventricular arrhythmias underwent the procedure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal in a period between October 2003 to September 2011. Results - The success rate is high (92%) and the complication rate is low (0.8%) which is comparable to the results shown in various literatures. Conclusion - Cardiac Electrophysiological study and Radiofrequency ablation is fairly safe and provides a definitive cure to the patients with paroxysmal supraventricular tachycardia. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5831 Journal of Advances in Internal Medicine. 2012; 1(1): 4-7

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