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Rodriguez Muñoz D, Ramos Jimenez J, Marco Del Castillo Á, Lozano Granero C, García Alberola A, Jiménez Sánchez D, Guntúriz Beltrán C, Ramos Ruiz P, Arias MÁ, Di Nubila B, Betancur A, González Torrecilla E, Dallaglio P, Alonso Fernández P, Ayala More HD, Calero S, Lumia G, Salgado Aranda R, Lázaro Rivera C, Rodríguez Mañero M, Syed A, Arribas Ynsaurriaga F, Salguero-Bodes R. Symptom burden guiding invasive electrophysiological study in paroxysmal supraventricular tachycardia: The believe SVT registry. Am Heart J 2024; 269:15-24. [PMID: 38042457 DOI: 10.1016/j.ahj.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/04/2023] [Accepted: 11/18/2023] [Indexed: 12/04/2023]
Abstract
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.
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Affiliation(s)
- Daniel Rodriguez Muñoz
- Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain.
| | - Javier Ramos Jimenez
- Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Álvaro Marco Del Castillo
- Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | | | | | | | | | - Pablo Ramos Ruiz
- Cardiology Department, University Hospital Santa Lucía, Cartagena, Spain
| | | | - Bruna Di Nubila
- Cardiology Department, St. Bartholomew's Hospital, London, United Kingdom
| | - Andrés Betancur
- Cardiology Department, University Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | | | - Paolo Dallaglio
- Cardiology Department, Bellvitge University Hospital, Barcelona, Spain
| | | | | | - Sofía Calero
- Cardiology Department, University Hospital Albacete, Albacete, Spain
| | - Giuseppe Lumia
- Cardiology Department, University Hospital Sant'Eugenio, Rome, Italy
| | | | - Carla Lázaro Rivera
- Cardiology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Moisés Rodríguez Mañero
- Cardiology Department, University Hospital Santiago de Compostela, Santiago de Compostela, Spain
| | - Ahsan Syed
- Cardiology Department, St. Bartholomew's Hospital, London, United Kingdom
| | - Fernando Arribas Ynsaurriaga
- Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Rafael Salguero-Bodes
- Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
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Cunningham JM, Borne R. Taking Time With the RP Interval in Narrow Complex Tachycardia. JAMA Intern Med 2021; 181:988-989. [PMID: 34028502 DOI: 10.1001/jamainternmed.2021.1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- John M Cunningham
- Division of Internal Medicine, Denver Health and Hospital Authority, Denver, Colorado.,Department of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Ryan Borne
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora
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