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首页> 外文期刊>Europace: European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology >Correlations between long-term results after cryoablation for atrioventricular nodal reentry tachycardia and a residual jump associated or not with a single echo.
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Correlations between long-term results after cryoablation for atrioventricular nodal reentry tachycardia and a residual jump associated or not with a single echo.

机译：冷冻消融后房室结折返性心动过速的长期结果与单跳相关或不相关的残余跳跃之间的相关性。

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While in radiofrequency ablation for atrioventricular nodal reentry tachycardia (AVNRT) a residual jump and a single echo do not seem to substantially modify long-term results, in cryoablation procedures their effects are still under evaluation. The purpose of this study was to evaluate if a residual jump associated or not with an isolated echo is correlated with outcome.Inclusion criteria: acute successful slow pathway cryoablation for slow-fast AVNRT. Exclusion criteria: use of a 4 mm tip cryocatheter, no baseline elicitable jump or inducible AVNRT, and unwanted persistent first degree atrioventricular (AV) block at the end of the procedure. Cryoablation (-80°C × 4 min) was applied after successful cryomapping. Atrioventricular nodal reentry tachycardia inducibility was checked 30 min later on and off isoproterenol. Acute success was defined as AVNRT non-inducibility. Among 332 patients (pts) who had undergone cryoablation from May 2002 to March 2010 in our institutions, 245 of them fulfilled the entry criteria (173 women, mean age 41 ± 16 years, ineffective drugs 1.3 ± 1.1). A 7-Fr 6-mm tip cryocatheter (CryoCath?) was used in all cases. Baseline AV nodal effective refractory period (ERP) was 271 ± 55 ms, post-procedural ERP 331 ± 60 ms (P< 0.001), and the mean of the difference between baseline and post-procedural ERP 63 ± 38 ms. A/V ratio at successful site was 1 ± 0.4. Forty-four pts (18%) had a residual jump at the end of the procedure, and 14 of them had an associated single echo. Global cryoapplication time was 993 ± 797 s. During a follow-up of 40 ± 10 months, 43 pts (17.5%) had recurrences. At 12 months follow-up, actuarial rate of recurrence-free pts was 85% in the group without residual jump (201 pts), 63.3% with residual jump and no echo (30 pts), and 60.6% with residual jump associated with a single echo (P< 0.003 among groups). Univariate predictors of recurrences were persistence of a residual jump (P< 0.001) and total cryoapplication time (P< 0.02). In a multivariate model, only residual jump was independently correlated with recurrences (P< 0.01).In patients undergoing AVNRT cryoablation, slow-pathway suppression is correlated with a better outcome. A single echo is associated with a recurrence risk similar to residual jump without echo. It may be suggested that pursuing a procedural endpoint up to slow pathway complete suppression may improve long-term success.
机译：虽然在射频消融房室结折返性心动过速（AVNRT）中，残留跳跃和单次回声似乎并不能显着改变长期结果，但在冷冻消融过程中，其效果仍在评估中。这项研究的目的是评估残余跳跃是否与孤立的回声相关联。纳入标准：急性成功的慢速冷冻消融用于慢速AVNRT。排除标准：使用4 mm尖端冷冻导管，在手术结束时无基线可诱发的跳跃或可诱发的AVNRT，并且无用的持久性一级房室（AV）阻滞。成功冷冻切片后，进行冷冻消融（-80°C×4分钟）。 30分钟后检查异丙肾上腺素的上下房室结折返性心动过速的可诱导性。急性成功定义为AVNRT不可诱导。在我们机构中自2002年5月至2010年3月接受冷冻消融的332例患者中，有245例符合入组标准（173名女性，平均年龄41±16岁，无效药物1.3±1.1）。在所有情况下均使用7-Fr 6-mm尖端冷冻导管（CryoCath？）。基线AV结节有效不应期（ERP）为271±55 ms，术后ERP为331±60 ms（P <0.001），基线与术后ERP的差均值为63±38 ms。成功部位的A / V比为1±0.4。在该过程结束时，有44个百分点（18％）出现残余跳跃，其中有14个具有相关的单次回声。全球低温应用时间为993±797 s。在40±10个月的随访中，有43例（17.5％）复发。在随访的12个月中，无残留跳动的组中无复发点的精算率为85％（201 pts），有残留跳动和无回声的组中的无复发跳动的精算率（30 pts），有残留跳动的60.6％。单回波（组间P <0.003）。复发的单因素预测因素是残留跳跃的持续性（P <0.001）和总冷冻应用时间（P <0.02）。在多变量模型中，仅残留跳跃与复发独立相关（P <0.01）。接受AVNRT冷冻消融的患者中，慢路径抑制与更好的预后相关。单个回声与类似于无回声的残留跳跃的复发风险相关。可能有人建议，采取程序性终点直至缓慢抑制通路完全抑制可能会改善长期成功率。

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