Mustafa Yıldız, Ahmet Çağrı Aykan, Halil İbrahim Tanboğa, Tayyar Gökdeniz, Çetin Gül

Atriyoventriküler Nodal Reentran Taşikardide Yavaş Yolun Transvenöz Radyofrekans ile Ablasyonunda Başvuru Hemoglobin Seviyeleri ve Cinsiyet Farklılığının Değerlendirilmesi

Giriş: Atriyoventriküler nodal reentran taşikardi insanda en sık gözlenen düzenli supraventriküler aritmidir. Bu çalışmada, atriyoventriküler nodal reentran taşikardide yavaş yolun transvenöz radyofrekans ile ablasyonunda başvuru hemoglobin seviyeleri ve cinsiyet farklılığı araştırılmıştır. Hastalar ve Yöntem: Semptomatik, ilaca dirençli tipik (yavaş-hızlı) atriyoventriküler nodal reentran taşikardisi olan 19 ardışık hasta, invaziv elektrofizyoloji çalışması ve atriyoventriküler yavaş iletim yolunun radyofrekans ablasyonu için çalışmaya alındı. Sabah saat 08.30- 09.30 aralarında tam kan sayımı için antekübital venden kan örneği alındı. Bulgular: Yavaş-hızlı atriyoventriküler nodal reentran taşikardisi olan (12 kadın, 7 erkek) 19 ardışık hasta ablate edildi. Ortalama başvuru hemoglobin ve hematokrit (%) değerleri erkeklerde kadınlara göre daha yüksekti (sırası ile, 15.38 ± 1.21 mg/dL, 12.72 ± 1.36 mg/dL, p < 0.001; 45.41 ± 3.26, 37.90 ± 2.88, p < 0.001). Radyasyon maruziyet zamanı, floroskopi zamanı, komplikasyon oranı (%0) ve akut başarı oranı (%100) açısından cinsiyet farklılığı yoktu. Sonuç: Atriyoventriküler nodal reentran taşikardinin transvenöz radyofrekans ablasyonu ile tedavisinde radyasyon maruziyet zamanı, floroskopi zamanı, komplikasyon oranı ve akut başarı oranı açısından cinsiyet farklılığı saptanmamıştır. Başvuru ortalama hemoglobin ve hematokrit değerleri kadınlarda erkeklere göre daha düşüktür

Anahtar Kelimeler:

Taşikardi, atriyoventriküler düğüm yeniden girişi; ablasyon teknikleri; cinsiyet farklılığı; hemoglobin seviyeleri.

Assessment of Admission Hemoglobin Levels and Gender Differences in Transvenous Radiofrequency Ablation Therapy for the Treatment of the Slow Pathway of Atrioventricular Nodal Reentrant Tachycardia

Introduction: Atrioventricular nodal reentrant tachycardia is the most common regular supraventricular arrhythmia in humans. This study investigated the admission hemoglobin levels and gender differences in transvenous radiofrequency ablation therapy for the treatment of the slow pathway of atrioventricular nodal reentrant tachycardia. Patients and Methods: Nineteen consecutive patients with symptomatic drug-resistant typical slow-fast atrioventricular nodal reentrant tachycardia underwent an invasive electrophysiology study and performed radiofrequency ablation of slow conduction pathway within atrioventricular node. Blood samples were taken between 08.30 and 09.30 a.m. from the antecubital vein for complete blood count. Results: Nineteen consecutive patients with slow-fast atrioventricular nodal reentrant tachycardia (12 female, 7 male) were ablated. Mean admission hemoglobin and hematocrit (%) levels were significantly increased in male patients as compared with female patients (15.38 ± 1.21 mg/ dL, 12.72 ± 1.36 mg/dL, p < 0.001; 45.41 ± 3.26, 37.90 ± 2.88, p < 0.001 respectively). There was not gender differences in the radiation exposure time, fluoroscopy time, complication rate (0%) and acute success rate (100%).Conclusion: There was not gender differences in the radiation exposure time, fluoroscopy time, complication rate and acute success rate at the transvenous radiofrequency ablation therapy for the treatment of atrioventricular nodal reentrant tachycardia. Mean admission hemoglobin and hematocrit levels were significantly decreased in female patients as compared with male patients.

Keywords:

Tachycardia, atrioventricular nodal reentry; ablation techniques; sex differences; hemoglobinometry.,

PDF

___

Katritsis DG, Camm AJ. Classification and differential diagnosis of atrioventricular nodal re-entrant tachycardia. Europace 2006;8:29- 36.
Katritsis DG, Camm AJ. Atrioventricular nodal reentrant tachycar- dia. Circulation 2010;122:831-40.
Chen J, Anselme F, Smith TW, Zimetbaum P, Epstein LM, Papa- georgiou P, et al. Standard right atrial ablation is effective for atrio- ventricular nodal reentry with earliest activation in the coronary sinus. J Cardiovasc Electrophysiol 2004;15:2-7.
Nam GB, Rhee KS, Kim J, Choi KJ, Kim YH. Left atrionodal con- nections in typical and atypical atrioventricular nodal re-entrant tachycardias: activation sequence in the coronary sinus and re- sults of radiofrequency catheter ablation. J Cardiovasc Electro- physiol 2006;17:1-7.
Yildiz M, Aykan AC, Kahveci G, Demir S, Ozkan M. Transvenous radiofrequency ablation therapy as an effective and safe method for the treatment of the slow pathway of atrioventricular nodal re- entrant tachycardia. Kosuyolu Kalp Derg 2011;14:51-5.
Suenari K, Hu YF, Tsao HM, Tai CT, Chiang CE, Lin YJ, et al. Gen- der differences in the clinical characteristics and atrioventricular nodal conduction properties in patients with atrioventricular nodal reentrant tachycardia. J Cardiovasc Electrophysiol 2010;21:1114-9.
Dagres N, Clague JR, Breithardt G, Borggrefe M. Significant gender-related differences in radiofrequency catheter ablation therapy. J Am Coll Cardiol 2003;42:1103-7.
Liu K, Ballew C, Jacobs DR Jr, Sidney S, Savage PJ, Dyer A, et al. Ethnic differences in blood pressure, pulse rate, and related characteristics in young adults. The CARDIA study. Hypertension 1989;14:218-26.
Huikuri HV, Pikkujamsa SM, Airaksinen KE, Ikaheimo MJ, Ran- tala AO, Kauma H, et al. Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. Circulation 1996;94:122-5.
Rosano GM, Leonardo F, Sarrel PM, Beale CM, De Luca F, Collins P. Cyclical variation in paroxysmal supraventricular tachycardia in women. Lancet 1996;347:786-8.
Rosano GM, Leonardo F, Dicandia C, Sheiban I, Pagnotta P, Pap- pone C, et al. Acute electrophysiologic effect of estradiol 17beta in menopausal women. Am J Cardiol 2000;86:1385-7, A5-6.
Goldstein DS, Levinson P, Keiser HR. Plasma and urinary cat- echolamines during the human ovulatory cycle. Am J Obstet Gy- necol 1983;146:824-9.
Duke M, Abelmann WH. The hemodynamic response to chronic anemia. Circulation 1969;39:503-13.
Schinasi DA, Schapiro E, Shah M. Ectopic atrial tachycardia in an infant with transient erythroblastopenia of childhood. Pediatr Emerg Care 2011;27:657-9.

ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi