The impact of His bundle location and direction on the efficacy and safety of ablation.

Pacing Clin Electrophysiol

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, P.R. China.

Published: October 2024

AI Article Synopsis

  • The study explores how the His bundle's location and its distance from the ablation site impact the success of atrioventricular nodal re-entrant tachycardia (AVNRT) and atrioventricular re-entrant tachycardia (AVRT) procedures, particularly focusing on patient factors like age, height, and BMI.
  • A total of 446 patients were analyzed, revealing that in AVNRT, a shorter distance between the His bundle and ablation site correlated with higher recurrence rates of supraventricular tachycardia.
  • While some correlations were noted, especially in relation to age, further research with larger sample sizes is suggested to better understand the implications on complications like third-degree atriov

Article Abstract

Background: The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (D) affects ablation safety and efficacy.

Methods: Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (D), the height of the His bundle (H), and D were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications.

Results: Multiple linear regression showed that H was negatively correlated with age in both groups. In AVNRT patients, D was associated with age, height, and BMI; D was only negatively correlated with age. In AVRT patients, there was no significant correlation between the D and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with D ≤ 10 mm had a higher recurrence rate than those with D> 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%.

Conclusions: H was negatively correlated with age but not with height and BMI. The D correlated with age, height, and BMI in AVNRT patients. A short D led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.

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Source
http://dx.doi.org/10.1111/pace.15053DOI Listing

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