Joerg Lauschke1, Julia Schneider2, Ralph Schneider2, Catharina Nesselmann3, Tina Tischer2, Aenne Glass4, Dietmar Bänsch2. 1. Department of Cardiology, University Medical Center, Ernst-Heydemann-Str. 6, Rostock 18059, Germany joerg.lauschke@uni-rostock.de. 2. Department of Cardiology, University Medical Center, Ernst-Heydemann-Str. 6, Rostock 18059, Germany. 3. Department of Cardiac Surgery, University Medical Center, Schillingallee 35, Rostock 18057, Germany. 4. Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center, Ernst-Heydemann-Str. 8, Rostock 18057, Germany.
Abstract
AIMS: A significant proportion of patients presenting with paroxysmal supraventricular tachycardia (PSVT) has no electrocardiogram (ECG) documentation. In these patients an electrophysiological study (EPS) may be performed to facilitate the diagnosis. METHODS AND RESULTS: In a prospective registry we compared the prevalence of inducible arrhythmias and the clinical outcome in 525 patients with and without ECG documentation. Compared with patients with a documented PSVT a smaller but substantial proportion of patients (63.7%) without ECG documentation had inducible supraventricular tachycardias (SVT). Atrio-ventricular nodal reentrant tachycardia was the most common type in both groups. Patients with an inducible SVT and no documentation were significantly younger, had a shorter episode duration and a lower hospitalization rate, which may be the cause for the lacking documentation. Similar to patients with documented PSVTs most of these patients (90.0%) were asymptomatic or clinically improved after the EPS. Even 43% of patients without an inducible tachycardia improved clinically, probably due to a placebo effect of the EPS. In particular, patients between 31 and 60 years of age seemed to benefit from an EPS because they were more likely to have inducible SVTs that could be cured by radiofrequency ablation. CONCLUSION: Our data show that a substantial proportion of patients with suspected paroxysmal tachycardia, but without ECG documentation, have inducible SVTs and obtain a clear clinical benefit from an EPS. Thus, our data provide justification for using EPS for patients in this category. To the best of our knowledge, ours is the first prospective registry that supports this approach. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: A significant proportion of patients presenting with paroxysmal supraventricular tachycardia (PSVT) has no electrocardiogram (ECG) documentation. In these patients an electrophysiological study (EPS) may be performed to facilitate the diagnosis. METHODS AND RESULTS: In a prospective registry we compared the prevalence of inducible arrhythmias and the clinical outcome in 525 patients with and without ECG documentation. Compared with patients with a documented PSVT a smaller but substantial proportion of patients (63.7%) without ECG documentation had inducible supraventricular tachycardias (SVT). Atrio-ventricular nodal reentrant tachycardia was the most common type in both groups. Patients with an inducible SVT and no documentation were significantly younger, had a shorter episode duration and a lower hospitalization rate, which may be the cause for the lacking documentation. Similar to patients with documented PSVTs most of these patients (90.0%) were asymptomatic or clinically improved after the EPS. Even 43% of patients without an inducible tachycardia improved clinically, probably due to a placebo effect of the EPS. In particular, patients between 31 and 60 years of age seemed to benefit from an EPS because they were more likely to have inducible SVTs that could be cured by radiofrequency ablation. CONCLUSION: Our data show that a substantial proportion of patients with suspected paroxysmal tachycardia, but without ECG documentation, have inducible SVTs and obtain a clear clinical benefit from an EPS. Thus, our data provide justification for using EPS for patients in this category. To the best of our knowledge, ours is the first prospective registry that supports this approach. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Christian von Bary; Lars Eckardt; Daniel Steven; Hans-Ruprecht Neuberger; Roland Richard Tilz; Hendrik Bonnemeier; Dierck Thomas; Thomas Deneke; Heidi L Estner; Malte Kuniss; Armin Luik; Philipp Sommer; Frederik Voss; Christian Meyer; D I Shin; Charalampos Kriatselis Journal: Herzschrittmacherther Elektrophysiol Date: 2015-12