Abstract
Abstract Background and objective The incidence of atrioventricular nodal reentrant tachycardia (AVNRT) in elderly patients has increased due to an increased in life expectancy of the general population. Slow pathway (SPs) ablation is considered the treatment of choice for patients with AVNRT. This study is interested in the relationship of the distance from SPs to His bundle electrogram (HBEs) in various age groups because understanding of anatomy clearly could guide treatment patients by using radiofrequency ablation to be easier and safer. Design and methods A cross-sectional study was analyzed in patients diagnosed with AVNRT and underwent SPs ablation using EnSite NavX mapping system guided therapy. The distance from SPs to the lowest HBEs recorded was measured. Relationship between distance from SPs to HBEs and age was analyzed by Pearson correlation. Results A total 68 adults diagnosed with AVNRT (27.9% males, mean age 52.43 years old) were included. The mean distance from SPs to HBEs is shorter in the group older than or equal to 60 years old (n=24, mean age 70.70 years old) compared to the group younger than 60 years old (n=44, mean age 42.45 years old) (13.77 vs. 17.73 millimeter, p=0.024). Average fluoroscopy time was greater in the older group compared to the younger group (24.43 vs. 16.52 minutes, p=0.002) while the procedure time in both groups was not different (105.1 vs. 85.48 minutes, p=0.09). The distance from SPs to HBEs was negative correlation with age with the coefficient of −0.392 (p<0.001). When dividing the age group into three age groups, the group that younger than 40 years old (n=15, mean age 29.73 years old), 40 to 60 years old (n=29, mean age 49.03) and older than 60 years old (n=24, mean 70.70 age), the average distance from SPs to HBEs was 20.77, 16.15 and 13.77 millimeter respectively. The mean distance from SPs to HBEs in the group younger than 40 years old is significant statistically different to the group that is older than 60 years old (p=0.006). Slow pathway ablation was successful in all patients in this study except for one patient who was 72 years old because frequent transient atrioventricular block occurred during ablation. Conclusion Distance from SPs to HBEs was negative correlation with age by measuring with 3-dimentional mapping. Distance from SPs to HBEs in each groups Funding Acknowledgement Type of funding source: None
Published Version
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