open access

Vol 11, No 1 (2016)
Original Papers
Published online: 2016-03-01
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Assessment of the clinical presentation and factors affecting the natural history of typical atrioventricular nodal reentrant tachycardia

Radoslaw Marek Kiedrowicz, Jarosław Kaźmierczak, Maciej Wielusiński
DOI: 10.5603/FC.2016.0002
·
Folia Cardiologica 2016;11(1):10-18.

open access

Vol 11, No 1 (2016)
Original Papers
Published online: 2016-03-01

Abstract

Introduction. Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular tachyarrhythmia; however, its clinical presentation has not been investigated in detail. The aim of the study was to assess the clinical presentation and identify the potential factors significantly affecting the natural history of AVNRT in patients undergoing RF ablation.

Material and methods. Ninety-two consecutive patients with invasive diagnosis of typical AVNRT who underwent RF ablation were included. All patients were actively screened for the presence of structural heart disease (SHD). The retrospective, arrhythmia focused interviews regarding its clinical history, affecting factors and treatment were conducted. The medical records and tachycardia ECG tracings data were included, if available.

Results. Seventy-five percent of patients had evidence of the arrhythmia exacerbation. No relationship between the coronary (66%) or brain (33%) hypoperfusion symptoms and clinical factors was found. Time to the tachycardia diagnosis was significantly longer in women (13 ± 11 vs 7 ± 8 years, p = 0.006). Pharmacological AVNRT management was not consistent with the ESC guidelines. The arrhythmia symptoms were occurring later if SHD was present (44 ± 13 vs 30 ± 5 years, p = 0.001). The longer AVNRT cycle length (CL), modified by the age when symptoms appeared and the presence of impaired myocardial contractility, the longer time to the arrhythmia diagnosis and exacerbation. Mitral valve prolapse (MVP) was more common in female patients compared with the general population and was found to be the factor delaying AVNRT diagnosis.

Conclusions. In the majority of patients AVNRT exacerbation takes place. The coronary and brain hypoperfusion symptoms that patients often experience are nonspecific. There is a significant delay in the arrhythmia diagnosis, especially in women. SHD, AVNRT CL and MVP were identified as factors that significantly modify the arrhythmia clinical presentation.  

Abstract

Introduction. Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular tachyarrhythmia; however, its clinical presentation has not been investigated in detail. The aim of the study was to assess the clinical presentation and identify the potential factors significantly affecting the natural history of AVNRT in patients undergoing RF ablation.

Material and methods. Ninety-two consecutive patients with invasive diagnosis of typical AVNRT who underwent RF ablation were included. All patients were actively screened for the presence of structural heart disease (SHD). The retrospective, arrhythmia focused interviews regarding its clinical history, affecting factors and treatment were conducted. The medical records and tachycardia ECG tracings data were included, if available.

Results. Seventy-five percent of patients had evidence of the arrhythmia exacerbation. No relationship between the coronary (66%) or brain (33%) hypoperfusion symptoms and clinical factors was found. Time to the tachycardia diagnosis was significantly longer in women (13 ± 11 vs 7 ± 8 years, p = 0.006). Pharmacological AVNRT management was not consistent with the ESC guidelines. The arrhythmia symptoms were occurring later if SHD was present (44 ± 13 vs 30 ± 5 years, p = 0.001). The longer AVNRT cycle length (CL), modified by the age when symptoms appeared and the presence of impaired myocardial contractility, the longer time to the arrhythmia diagnosis and exacerbation. Mitral valve prolapse (MVP) was more common in female patients compared with the general population and was found to be the factor delaying AVNRT diagnosis.

Conclusions. In the majority of patients AVNRT exacerbation takes place. The coronary and brain hypoperfusion symptoms that patients often experience are nonspecific. There is a significant delay in the arrhythmia diagnosis, especially in women. SHD, AVNRT CL and MVP were identified as factors that significantly modify the arrhythmia clinical presentation.  

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Keywords

atrioventricular nodal reentrant tachycardia; structural heart disease, arrhythmia exacerbation

About this article
Title

Assessment of the clinical presentation and factors affecting the natural history of typical atrioventricular nodal reentrant tachycardia

Journal

Folia Cardiologica

Issue

Vol 11, No 1 (2016)

Pages

10-18

Published online

2016-03-01

DOI

10.5603/FC.2016.0002

Bibliographic record

Folia Cardiologica 2016;11(1):10-18.

Keywords

atrioventricular nodal reentrant tachycardia
structural heart disease
arrhythmia exacerbation

Authors

Radoslaw Marek Kiedrowicz
Jarosław Kaźmierczak
Maciej Wielusiński

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