Cycling of inducibility of paroxysmal supraventricular tachycardia in women and its implications for timing of electrophysiologic procedures
Key result
Electrophysiologic testing during low estrogen states induces SVT in ~100% of previously negative women.
- n=42
Why the study?
Arrhythmias in women may be affected by phases of the menstrual cycle, and the prevalence of perimenstrual clustering of paroxysmal SVT and its impact on electrophysiologic testing inducibility were unclear.
Does timing electrophysiologic testing at low estrogen states improve the inducibility of paroxysmal SVT in women with perimenstrual clustering compared to high estrogen states?
Population
42 women with spontaneous paroxysmal SVT referred during a 3-year period
Comparison
Electrophysiologic testing at low estrogen states vs higher estrogen states
Design
Prospective observational cohort study
Authors
Discussion
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Member takes
Implication
May support timing EP testing to low-estrogen states in perimenstrual SVT; leaves open need for prospective validation before practice change.
Study Design
Type
Observational (n=42)
Structured PICO
Does timing electrophysiologic testing at low estrogen states improve the inducibility of paroxysmal SVT in women with perimenstrual clustering compared to high estrogen states?
P
Population
42 women with spontaneous paroxysmal supraventricular tachycardia referred over a 3-year period.
E
Exposure
Electrophysiologic testing at low estrogen states (premenstrual, at the onset of menses, or after stopping estrogen replacement therapy)
C
Comparator
Electrophysiologic testing at higher estrogen states (midcycle or with estrogen replacement therapy)
O
Outcome
Inducibility of paroxysmal SVT during electrophysiologic testingsurrogate
Main Result
Absolute Event Rate: 100% vs 0%
Scheduling elective electrophysiologic procedures during low estrogen states may improve SVT inducibility and ablation success in women with perimenstrual clustering of arrhythmias.
Cite This Study
Myerburg et al. (1999) conducted an observational in Paroxysmal supraventricular tachycardia (n=42). Low estrogen states (premenstrual or off estrogen replacement therapy) vs. High estrogen states (midcycle or on estrogen replacement therapy) was evaluated on Inducibility of paroxysmal SVT during electrophysiologic testing. Electrophysiologic testing during low estrogen states successfully induced paroxysmal SVT in 6 of 6 women (100%) who had previously negative studies during high estrogen states.