Characteristics of patients-candidates for atrioventricular node ablation with tachycardiomyopathy due to atrial fibrillation
https://doi.org/10.51922/2616-633X.2022.6.2.1673
Abstract
Aim. To assess the functional status, the state of ECG parameters, parameters of cardiac hemodynamics and quality of life in patients candidates for ablation of the atrioventricular node with the implantation of pacemakers, resynchronization devices (CRT) due to tachyform of atrial fibrillation.
Materials and methods: the study included 61 patients with a mean age of 59.4 ± 10.4 years, BMI 31.3 ± 5.8; test 6-min. walk 315 ± 173 m. Group 1 pacemaker – patients with implanted pacemaker 19 people, group 2 CRT – 42 people. Quality of life according to the Minnesota questionnaire in the cohort – 49 [32; 65] points (unsatisfactory), CHF FC 2 in general and FC 3 in the pacing group and FC 2 in the CRT group, but no significant differences. The mean QRS duration was 115 [90.146], ms. no significant differences between groups. Only the ratio of R6/S6 and the value of (S1+R6)-(S6+R1) were significantly different in subgroups with different QRS widths, which may be a predictor of the effectiveness of electrocardiotherapy. Ejection fraction (EF) was 32.0 ± 7.6% due to tachycardiomyopathy. Signs of interventricular and intraventricular dyssynchrony were registered.
Conclusion: patients with tachycardiomyopathy have signs of a significant decrease in the quality of life and cardiac function, however, these changes, apparently, are not due to the width of the QRS complex, the presence of dyssynchrony and the criteria for referring to CRT therapy, but primarily tachysystole and a decrease in the overall contractility of the myocardium.
About the Authors
A. Chasnoits
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
Ye. Rebeko
Republican Scientific and Practical Center of Cardiology
Bhutan
Bhutan
Minsk
D. Goncharik
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
V. Barsukevich
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
L. Plashchinskaya
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
O. Kovalenko
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
O. Podpalova
Republican Scientific and Practical Center of Cardiology
Belarus
Belarus
Minsk
References
1. Packer D.L., Bardy G.H., Worley S.J., Smith M.S., Cobb F.R., Coleman R.E., Gallagher J.J., German L.D. Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction. Am J Cardiol, 1986, vol. 57, no. 8, pp. 563–570. doi: 10.1016/0002-9149(86)90836-2.
2. Gossage A.M., Braxton Hicks J.A. On auricular fibrillation. Q J Med, 1913, vol. 6, pp. 435–440.
3. Persidskikh Yu.A., Rebeko E.S., Chasnojt’ A.R., Goncharik D.B., Barsukevich V.Ch., Plashchinskaya L.I. Takhiinducirovannaya kardiomiopatiya: patofiziologiya, diagnostika i lechenie [Induced cardiomyopathy: pathophysiology, diagnosis and treatment]. Kardiologiya v Belarusi, 2020, vol. 12, no. 6, pp. 874–887. (in Russian).
4. Chugh S.S., Havmoeller R., Narayanan K., Singh D., Rienstra M., Benjamin E.J., Gillum R.F., Kim Y.H., McAnulty J.H.Jr, Zheng Z.J., Forouzanfar M.H., Naghavi M., Mensah G.A., Ezzati M., Murray C.J. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation, 2014, vol. 129, pp. 837–847.
5. Glikson M., Nielsen J.C., Kronborg M.B., Michowitz Y., Auricchio A., Barbash I.M., Barrabés J.A., Boriani G., Braunschweig F. [et al.] 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J, 2021, vol. 42, no. 35, pp. 3427–3520. doi: 10.1093/eurheartj/ehab364.
6. Tomita M., Spinale F.G., Crawford F.A., Zile M.R. Changes in left ventricular volume, mass, and function during the development and regression of supraventricular tachycardia-induced cardiomyopathy. Disparity between recovery of systolic versus diastolic function. Circulation, 1991, vol. 83, no. 2, pp. 635–644.
7. Shinbane J.S., Wood M.A., Jensen D.N., Ellenbogen K.A., Fitzpatrick A.P., Scheinman M.M. Tachycardia-induced cardiomyopathy: a review of animal models and clinical studies. J Am Coll Cardiol, 1997, vol. 29, no. 4, pp. 709–715.
8. Maisel W.H., Stevenson L.W. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol, 2003, vol. 91, no. 6A, pp. 2D–8D.
9. Santhanakrishnan R., Wang N., Larson M.G., Magnani J.W., McManus D.D., Lubitz S.A., Ellinor P.T., Cheng S., Vasan R.S., Lee D.S., Wang T.J., Levy D., Benjamin E.J., Ho J.E. Atrial fibrillation begets heart failure and vice versa: temporal associations and differ-ences in preserved vs. reduced ejection fraction. Circulation, 2016, vol. 133, no. 5, pp. 484–492
10. Simantirakis E.N., Prassopoulos V.K., Chrysostomakis S.I., Kochiadakis G.E., Koukouraki S.I., Lekakis J.P., Karkavitsas N.S., Vardas P.E. Effects of asynchronous ventricular activation on myocardial adrenergic innervation in patients with permanent dual-chamber pacemakers; an I(123)-metaiodobenzylguanidine cardiac scintigraphic study. Eur Heart J, 2001, vol. 22, no. 4, pp. 323–332.
11. Prabhu S., Voskoboinik A., Kaye D.M., Kistler P.M. Atrial fibrillation and heart failure - cause or effect? Heart Lung Circ, 2017, vol. 26, no. 9, pp. 967–974.
12. Clark D.M., Plumb V.J., Epstein A.E., Kay G.N. Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibril-lation. J Am Coll Cardiol, 1997, vol. 30, no. 4, pp. 1039–1045.
13. Chatterjee N.A., Upadhyay G.A., Ellenbogen K.A., McAlister F.A., Choudhry N.K., Singh J.P. Atrio-ventricular nodal ablation in atrial fibrillation: a meta-analysis and systematic review. Circ Arrhythm Electrophysiol, 2012, vol. 5, no. 1, pp. 68–76.
14. Spragg D.D., Dong J., Fetics B.J., Helm R., Marine J.E., Cheng A., Henrikson C.A., Kass D.A., Berger R.D. Optimal Left Ventricular Endocardial Pacing Sites for Cardiac Resynchronization Therapy in Patients With Ischе`ic Cardiomyopathy. J. of the Am. Coll. of Cardiol, 2010, vol. 56, no. 10, pp. 774–781.
15. Poposka L., Boskov V., Risteski D., Taleski J., Janusevski F., Srbinovska E., Georgievska-Ismail L. Electrocardiographic Parameters as Predictors of Response to Cardiac Resynchronization Therapy. Open Access Maced J Med Sci, 2018, vol. 6, no. 2, pp. 297–302. doi: 10.3889/oamjms.2018.092.
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For citations:
Chasnoits A., Rebeko Ye., Goncharik D., Barsukevich V., Plashchinskaya L., Kovalenko O., Podpalova O. Characteristics of patients-candidates for atrioventricular node ablation with tachycardiomyopathy due to atrial fibrillation. Emergency Cardiology and Cardiovascular Risks journal. 2022;6(2):1673-1680. (In Russ.) https://doi.org/10.51922/2616-633X.2022.6.2.1673
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