완속 전도로 절제 결과 평가를 위해 동율동시 투여한 Adenosine (Use of adenosine during sinus rhythm can identify impending heart blocking during cather ablation of AV nodal recentrant tachycardia)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 19권 / 1호 / 123 ~ 132페이지
· 저자명 : 노지훈, 이지현, 임대관, 박찬복, 김성만, 차태준, 주승재, 이재우

초록

Background : Atrioventricular nodal recentrant tachycardia (AVNRT) is the most common form of supraventriicular tachycardia. Radiofrequency catheter ablation (RFCA) of the slow pathway can treat AVNRT. Slow pathway ablation is associated with a risk of complete AV block in rare cases. In difficult cases, electrophysiologist should check degrees of atrioventricular node (AVN) damage during and after ablation. There are several methods of identifying high risk of slow pathway ablation and identifying degree of AVN damage, but sometimes there are not perfect. Adenosine is effective in AVNRT termination by influencing AVN conduction. Use of adenosine can identify change of AVN conduction properties.
Methods : Adenosine tests were studied in 24 patients (10 men, 14 women: 43.5±16.6 years) with inducible sustained AVNRT. Adenosine 6mg and 12mg were injected before and after successful ablation of slow pathway during sinus rhythm.
Results : With adenosine 6mg injection, AVNRT occurred in 13 patients and A-H jump in 15 patients before ablation, whereas AVNRT occurred in no patient and A-H jump in 5 patients after ablation. Adenosine 6mg induced AV block beats were significantly increased from 0.4±1.5 to 4.0±4.0 beats by ablation (p<0.05). And then adenosine 12mg were injected before and after ablation of slow pathway in 21 patients. AVNRT occurred in 13 versus 0 patient, A-H jump occurred in 16 versus 9 patients. The longest RR interval was 1590±714 versus 4245±3492 msec (p<0.05).
Conclusion : After successful RFCA of AVNRT, adenosine increases the number of AV block beats and the longest RR interval significantly. Administration of adenosine during and after ablation can identify severe AV nodal damage which was induced by ablation. Administration of adenosine during and after RFCA enables us to estimate amount of AV nodal damage and it give us information about when to stop the catheter ablation. Adenosine can be useful to identify patients with impending heart block during and after ablation of slow pathway.

영어초록

Background : Atrioventricular nodal recentrant tachycardia (AVNRT) is the most common form of supraventriicular tachycardia. Radiofrequency catheter ablation (RFCA) of the slow pathway can treat AVNRT. Slow pathway ablation is associated with a risk of complete AV block in rare cases. In difficult cases, electrophysiologist should check degrees of atrioventricular node (AVN) damage during and after ablation. There are several methods of identifying high risk of slow pathway ablation and identifying degree of AVN damage, but sometimes there are not perfect. Adenosine is effective in AVNRT termination by influencing AVN conduction. Use of adenosine can identify change of AVN conduction properties.
Methods : Adenosine tests were studied in 24 patients (10 men, 14 women: 43.5±16.6 years) with inducible sustained AVNRT. Adenosine 6mg and 12mg were injected before and after successful ablation of slow pathway during sinus rhythm.
Results : With adenosine 6mg injection, AVNRT occurred in 13 patients and A-H jump in 15 patients before ablation, whereas AVNRT occurred in no patient and A-H jump in 5 patients after ablation. Adenosine 6mg induced AV block beats were significantly increased from 0.4±1.5 to 4.0±4.0 beats by ablation (p<0.05). And then adenosine 12mg were injected before and after ablation of slow pathway in 21 patients. AVNRT occurred in 13 versus 0 patient, A-H jump occurred in 16 versus 9 patients. The longest RR interval was 1590±714 versus 4245±3492 msec (p<0.05).
Conclusion : After successful RFCA of AVNRT, adenosine increases the number of AV block beats and the longest RR interval significantly. Administration of adenosine during and after ablation can identify severe AV nodal damage which was induced by ablation. Administration of adenosine during and after RFCA enables us to estimate amount of AV nodal damage and it give us information about when to stop the catheter ablation. Adenosine can be useful to identify patients with impending heart block during and after ablation of slow pathway.

참고자료

· 없음