Document Detail


A higher than expected prevalence of AV nodal reentrant tachycardia in patients receiving implantable cardioverter-defibrillators.
MedLine Citation:
PMID:  21332561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Epidemiologic studies have indicated that the prevalence of paroxysmal supraventricular tachycardia (SVT) is approximately two to three of 1000 persons, of whom 50-60% have atrioventricular node reentrant tachycardia (AVNRT). Although SVT has been reported to account for a significant portion of inappropriate shocks in patients receiving implantable cardioverter-defibrillators (ICDs), the incidence of AVNRT is unknown.
OBJECTIVE: To define the incidence of AVNRT in patients with ICDs.
METHODS AND RESULTS: Of 426 patients followed with an ICD, 15 patients with AVNRT were identified (3.5%). AVNRT was noted preimplant in eight patients. One had remote AVNRT and had undergone radiofrequency (RF) ablation several years prior to ICD implantation. Three patients had known episodes and underwent RF ablation prior to ICD implant. Four had AVNRT induced at preimplant electrophysiology study and three had RF ablation prior to ICD implant. Seven patients had clinical episodes of AVNRT after ICD implant and six of seven received inappropriate ICD therapy for AVNRT. All seven patients underwent RF ablation for treatment of AVNRT. No patient who underwent RF ablation had further clinical episodes of SVT, and only one had further inappropriate ICD therapy for sinus tachycardia.
CONCLUSION: The substantially higher prevalence of AVNRT in our followed ICD population (3.5%) compared to the general population may be due to detection bias or electroanatomic changes in the atrioventricular nodal area induced by the accompanying heart disease. In any case, further studies to evaluate the inducibility of AVNRT prior to ICD implant, its prognostic implications, and the role of RF ablation to prevent inappropriate shocks are warranted.
Authors:
Jeffrey J Goldberger; Rod Passman; Rishi Arora; Alan H Kadish
Publication Detail:
Type:  Journal Article     Date:  2011-02-17
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  34     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-25     Completed Date:  2011-09-27     Revised Date:  2012-02-16    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  584-6     Citation Subset:  IM    
Copyright Information:
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Affiliation:
Bluhm Cardiovascular Center and the Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. j-goldberger@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Defibrillators, Implantable*
Female
Humans
Incidence
Male
Middle Aged
Prevalence
Prognosis
Risk Factors
Tachycardia, Atrioventricular Nodal Reentry / epidemiology*,  etiology,  physiopathology
Grant Support
ID/Acronym/Agency:
R01 HL093490-04/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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