Abstract
Paroxysmal supraventricular tachycardia (SVT) documentation is not always easy and in some patients referred for SVT ablation, EPS sometimes remains negative. The purpose of study was to evaluate the follow-up after esophageal EPS for no documented tachycardia. 1569 patients, mean age 42±19.5 years, 637 males, with normal ECG in sinus rhythm, were suspected of SVT. Exercise testing, 24 hour Holter monitoring were normal. Transesophageal EPS consisted of programmed stimulation with 1 and 2 extrastimuli in control state and after isoproterenol. EPS remained negative in 594 patients (group I). Atrial fibrillation/tachycardia (AF) was induced in 70 patients (group II), atrioventricular (AV) nodal reentrant tachycardia (AVNRT) or AVRT using a concealed accessory pathway in 887 patients (group III). Group I was younger (34±17 years) than group II (53±16), III (46±20)(p<0.001). Group II was older than group III (p<0.001). Group I was more frequently of female gender (62%) than group II (56.5%)(no difference with group II)(67%). Group I had more frequently associated dizziness/syncope (41%) or chest pain (22%) than group II (20, 5%) or III (19, 6%)(p<0.001). Associated moderate heart disease was more frequent in group II (15%) than in group I (4.5%)(p<0.001) or III (8%)(p<0.003). During follow-up (mean 5±4 years), tachycardia was documented in 21 group I patients (3.5%)(AF 11, AVNRT/AVRT 8, ventricular tachycardia 1), 18 group II patients (20%)(p<0.0001)(AF), 370 group III patients (42%)(p<0.0001)(AVNRT/AVRT 361, AF 9). 2 group II patients (3%), 13 group III patients (7%) died (p<0.003). Ablation (AF or AVNRT/AVRT) was performed in 8 group I patients (1%), 10 group II patients (11%)(p<0.001), 348 group III patients (39%)(p<0.0001). Prognosis value esophageal EPS was excellent. A negative study noted in younger patients complaining frequently of dizziness/syncope/ chest pain predicted a favorable prognosis. None of the patients with induced AF had AVNRT/AVRT and this group (older, with HD) had frequently AF during follow-up (20%). Patients with induced AVNRT/AVRT benefit frequently from ablation of their tachycardia.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
