Symptom burden guiding invasive electrophysiological study in paroxysmal supraventricular tachycardia: The believe SVT registry - 13/02/24
, Javier Ramos Jimenez, MD a, b, Álvaro Marco Del Castillo, MD, PhD a, b, Cristina Lozano Granero, MD c, Arcadio García Alberola, MD, PhD d, Diego Jiménez Sánchez, MD e, Clara Guntúriz Beltrán, MD f, Pablo Ramos Ruiz, MD g, Miguel Ángel Arias, MD PhD h, Bruna Di Nubila, MD i, Andrés Betancur, MD j, Esteban González Torrecilla, MD, PhD k, Paolo Dallaglio, MD, PhD l, Pau Alonso Fernández, MD, PhD m, Hebert David Ayala More, MD n, Sofía Calero, MD, PhD o, Giuseppe Lumia, MD p, Ricardo Salgado Aranda, MD, PhD q, Carla Lázaro Rivera, MD, PhD r, Moisés Rodríguez Mañero, MD, PhD s, Ahsan Syed, MD i, Fernando Arribas Ynsaurriaga, MD, PhD a, b, Rafael Salguero-Bodes, MD a, bRésumé |
Background and Objective |
Patients with palpitations clinically suggestive of paroxysmal supraventricular tachycardia (PSVT) are often managed conservatively until ECG-documentation of the tachycardia, leading to high impact on life quality and healthcare resource utilization. We evaluated results of electrophysiological study (EPS), and ablation when appropriate, among these patients, with special focus on gender differences in management.
Methods |
BELIEVE SVT is a European multicenter, retrospective registry in tertiary hospitals performing EPS in patients with palpitations, without ECG-documentation of tachycardia or preexcitation, and considered highly suggestive of PSVT by a cardiologist or cardiac electrophysiologist. We analyzed clinical characteristics, results of EPS and ablation, complications, and clinical outcomes during follow-up.
Results |
Six-hundred eighty patients from 20 centers were included. EPS showed sustained tachycardia in 60.9% of patients, and substrate potentially enabling AVNRT in 14.7%. No major/permanent complications occurred. Minor/transient complications were reported in 0.84% of patients undergoing diagnostic-only EPS and 1.8% when followed by ablation. During a 3.4-year follow-up, 76.2% of patients remained free of palpitations recurrence. Ablation (OR: 0.34, P < .01) and male gender (OR: 0.58, P = .01) predicted no recurrence. Despite a higher female proportion among patients with recurrence, (77.2% vs 63.5% among those asymptomatic during follow-up, P < .01), 73% of women in this study reported no recurrence of palpitations after EPS.
Conclusions |
EPS and ablation are safe and effective in preventing recurrence of nondocumented palpitations clinically suggestive of PSVT. Despite a lower efficacy, this strategy is also highly effective among women and warrants no gender differences in management.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Abbreviations : AF, AV, AVNRT, AVRT, ECG, EPS, QoL, PSVT
Plan
Vol 269
P. 15-24 - mars 2024 Retour au numéro
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