Catheter ablation of atrioventricular nodal reentry tachycardia and quality of life

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Objective To present the results of radiofrequency catheter ablation of patients with atrioventricular nodal reentry tachycardia (AVNRT). Materials and methods Catheter ablation was performed in 488 patients with AVNRT. The age of patients is from 14 to 66 (mean age 40.2±14.7 years). Comorbidities such as ischemic heart disease and hypertension were in 234 (48%) patients, in 83 (17%) patients chronic myocarditis was detected. No organic pathology from the cardiovascular system was detected in 171 (35%) patients. In the anamnesis, tachycardia attacks were observed from 2 to 29 years (on average, 18.7 ± 4.9 years). After confirming the diagnosis of typical "slow-fast" AVNRT on the intracardiac electrophysiological investigation, an ablation catheter was inserted into the heart of the patient. Then radiofrequency ablation of "slow paths" of AV-connection was performed. Traditionally, the quality of life associated with health is considered as an integral characteristic of a person’s physical, mental (emotional) and social well-being, based on his subjective perception of these attributes. We assessed the quality of life of patients with AVNRT using the SF-36 questionnaire and The Hospital Anxiety and Depression Scale (HADS) before and after performing of catheter radiofrequency ablation. Results In 488 patients, the criteria for the effectiveness of the destruction of the "slow pathways" were obtained and the effectiveness of the procedure was 99.38%. During the study of indicators of QOL according to the SF-36 questionnaire, wich was obtained 6 months after Radiofrequency Ablation (RFA), the most significant improvement was noted in terms of role functioning RF (by 48.6%), physical functioning PF (by 25.5%) and GH general health (19.7%). The BP bodily pain index, although increased (by 13.8%), but not reliably. After 12 months, we observed a significant improvement in QOL in all indicators of the physical component of health, which did not differ from those in the control group. Clinically manifested anxiety was observed in a reliably larger number of patients (63.6%). The total indicator of the anxiety level was 11.1±2.4 points and corresponded to clinically manifested anxiety. The majority (66.7%) of patients had a subclinical form of depression. The total value of the depression level was 9.8±1.8 points and corresponded to the indicator of subclinically manifested disorders. Testing on the hospital anxiety and depression assessment scale after 12 months showed that all patients had no significant symptoms of anxiety and depression. The total score of anxiety was -2.8±1.1 points (p<0.0001), depression - 2.4±1.4 (p<0.0001). Conclusions Radiofrequency catheter ablation is an effective, drastic and safe method of treating AVNRT, the effectiveness of the procedure reaches up to 100% and allows patients to improve their quality of life, get rid of the lifelong intake of antiarrhythmic drugs.