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A. Basics
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
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21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Atrial electrical impairment and atrial fibrillation after AV nodal reentrant tachycardia ablation
Session:
Painel 4 - Arritmologia 9
Speaker:
Rita Marinheiro
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.2 Supraventricular Tachycardia (non-AF) - Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Rita Marinheiro; Leonor Parreira; Pedro Campos Amador; Dinis Valbom Mesquita; José Maria Farinha; Ana Fátima Esteves; Marta Ferreira Fonseca; Joana Silva Ferreira; Antonio Pinheiro Cumena Candjondjo; Rui Caria
Abstract
<p>BACKGROUND: Atrial electrical conduction properties have been implicated in atrial fibrillation (AF) pathogenesis. Patients (pts) who underwent catheter ablation (CA) of atrioventricular nodal reentrant tachycardia (AVNRT) have a higher incidence of AF. Several atrial time measurements determined during electrophysiologic study (EPS) can reflect atrial electrical conduction impairment related with AF. Also conventional risk factors can play a role in AF development during the follow-up.</p> <p> </p> <p>AIMS: to evaluate atrial conduction times and assess its effect on AF development during follow-up.</p> <p> </p> <p>METHODS: We studied AVNRT pts who performed EPS and catheter ablation of the slow pathway between 2013 and 2016 in a single center. Pts with AF or valvular disease were excluded. We evaluated duration of symptoms due to AVNRT, conventional risk factors for AF (age, gender, obesity, hypertension, diabetes and structural heart disease (SHD)), left atrium (LA) enlargement and electrophysiologic study (EPS) time intervals related with atrial electrical conduction properties. We measured the time interval between: (1) the beginning of the P wave on the ECG to the A deflection in His-bundle electrogram (P-AHis); (2) the beginning of the P wave to the mid-distal coronary sinus (CS) atrial electrogram (P-CS) and (3) the beginning of the P wave to the H deflection in His-bundle electrogram (P-HHis).</p> <p> </p> <p>RESULTS: Fifty-two pts were evaluated during a median follow-up of 63 months (IQR 51-69): 22% male, median age 55 years (IQR 42-67). AF occurred in 9 patients (17%) (39 cases per 1000 person-years). Patients with AF were older (67 vs 53 years, p= 0.005) and had more frequently LA enlargement (33% vs 7%, p= 0.024) but they did not differ in hypertension, obesity, diabetes, SHD and duration of symptoms. EPS measured intervals P-AHis and P-HHis interval were not different between the groups (26.0 vs 22.8 ms, p=0.89 and 151 vs 106 ms, p= 0.56, respectively) but P-CS were prolonged in patients with AF (70 vs 55 ms, p=0.02) (figure A). Univariate logistic analysis for AF is presented in table 1. There was no interaction between P-CS and LA enlargement (p=0.87). In multiavariate analysis, only P-CS was independently associated with AF (figure B). </p> <p> </p> <p>CONCLUSIONS: In this group of patients with AVNRT, P-CS, but not other atrial conduction intervals, was independently associated with AF, suggesting a possible role of LA electrical conduction impairment in AF development in AVNRT pts.</p>
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