Key result
Radiofrequency catheter ablation significantly reduced heart palpitations and non-specific symptoms in patients with AVNRT, but did not significantly alter head-up tilt table test results.
Why the study?
Does radiofrequency catheter ablation affect autonomic function and symptoms in patients with atrioventricular nodal reentrant tachycardia?
Observational (n=22)
No
Does radiofrequency catheter ablation affect autonomic function and symptoms in patients with atrioventricular nodal reentrant tachycardia?
Absolute Event Rate: 9% vs 10%
p-value: p=1
Radiofrequency catheter ablation significantly improves heart palpitations and non-specific symptoms in patients with AVNRT, but does not significantly alter autonomic function as measured by HUTT and HRV indices at 1 month.
May improve symptoms without altering autonomic tests in AVNRT; leaves open HUTT utility and mechanisms pending RCTs.
BACKGROUND: One of the recommended treatments for atrioventricular nodal reentrant tachycardia (AVNRT), is radiofrequency catheter ablation (RFCA). However, RFCA may affect the autonomic system. This study aims to evaluate the effect of RFCA on autonomic system in patients with PSVT by head-up tilt table (HUTT) test. MATERIALS AND METHODS: In a before-after study, 22 patients with PSVT were enrolled. Data were collected with a data collection form that included two parts. Electrocardiogram (ECG), echocardiogram, 24-h Holter monitoring, HUTT test, heart rate variability (HRV) indexes, and symptoms of all patients were recorded 24 h before and 1 month after the ablation. Wilcoxon, McNemar, Mann-Whitney U, and Chi-square tests were used to analyze the data. RESULTS: Of the total 22 patients, 31.8% were male and 68.2% were female. There were significant differences in heart palpitation (P < 0.0001) and non-specific symptoms (P = 0.031) and no significant difference in head-up tilt test results and HRV indices before and after RFCA. The results showed that there were no significant differences in specific and non-specific symptoms in patients with AVNRT with positive and negative HUTT before and after RFCA. CONCLUSIONS: The observed difference in heart palpitation and non-specific symptoms emphasized the role of AVNRT in causing these symptoms. Autonomic dysfunction is more probably an accompanying condition of AVNRT than causing symptoms. We could not find any significance in the results of HUTT after RFCA. HUTT cannot determine or predict the symptoms after RFCA.
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Eftekharzadeh et al. (2015) conducted an observational in Atrioventricular nodal reentrant tachycardia (AVNRT) (n=22). Radiofrequency catheter ablation (RFCA) vs. Baseline (before RFCA) was evaluated on Positive head-up tilt table (HUTT) test (p=1). Radiofrequency catheter ablation significantly reduced heart palpitations and non-specific symptoms in patients with AVNRT, but did not significantly alter head-up tilt table test results.
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