A Study on Electrophysiologic Mechanism and Clinical Characteristics of Paroxysmal Supraventricular Tachycardia.
- Author:
Jay Young RHEW
1
;
Youl BAE
;
Jun Yoo KIM
;
Sung Hee KIM
;
Ju Han KIM
;
Gwang Chae GILL
;
Joo Hyung PARK
;
Myung Ho JEONG
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Jung Chaee KANG
Author Information
1. Department of Internal Medicine, Chonnam National University, Kwangju, Korea.
- Publication Type:Original Article
- Keywords:
Mechanisms of Paroxysmal supraventricular tachycardia;
PSVT;
Electrophysiologic study;
EPS;
Clinical manifestation
- MeSH:
Catheter Ablation;
Diagnosis;
Female;
Humans;
Jeollanam-do;
Korea;
Male;
Tachycardia;
Tachycardia, Atrioventricular Nodal Reentry;
Tachycardia, Sinoatrial Nodal Reentry;
Tachycardia, Supraventricular*;
Tertiary Care Centers;
Wolff-Parkinson-White Syndrome
- From:Korean Journal of Medicine
1997;52(2):199-208
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Accurate diagnosis of the mechanism and origin site of paroxysmal supraventricular tachycardia(PSVT) can be made using electrophysiologic study(EPS). Recently, radiofrequency catheter ablation technique has been introduced and widely used for the definitive treatment of various forms of PSVT, thereby precise determination of the mechanism of PSVT can be possible. It has been known that atrioventricular reentry tachycardia (AVRT) using concealed bypass tract is more frequent than atrioventricular nodal reentry tachycardia (AVNRT) in Korea. But it is not certain that those studies represent actual distribution of PSVT in Korea. This study was designed to determine the mechanism and clinical characteristics of PSVT in Korea. METHODS: We investigated 136patients in whom electrophysiolosic study was performed from October 1992 through October 1994 at the Chonnam National University Hospital, the only tertiary referral center of the Kwangju-Chonnam area of Korea. RESULTS: 1) The electrophysiologic mechanism of PSVT was AVNRT in 44patients(32.4%), WPW syndrome in 46(33.8%), AVRT using concealed bypass tract in 40(29.4%), sinoatrial nodal reentry tachycardia (SANRT) in 4(2.9%), and automatic atrial tachycardia(AAT) in 2(1.5%), ensuing that AVNRT is most common mechanism of PSVT with no preexcitation during sinus rhythm. 2) Male is more frequent than female in AVNRT, WPW syndrome, and AVRT, which was most prominent in WPW syndrome. 3) The first episode of symptom occured at the age of 34.9 +/- 17.3 years in AVNRT, 25.5 +/- 13.3 years in WPW and 26.3 +/- 15.0 years in AVRT(p<0.05). There was no significant difference in the duration of symptom. The tachycardia rate in WPW syndrome was 183.6 +/- 23.9 per minute and AVRT was 186.7 +/- 38.0 per minute, which were faster than that of AVNRT(161.7 +/- 28.6/min)(p<0.05). 4) There was no significant difference in the presenting symptoms and in the provocation factors between AVNRT and AVRT. CONCLUSION: AVNIlT is most common mechanism of PSVT with no preexcitation during sinus rhythm, developed at older age than WPW syndorme and AVRT, and had lower tachycardia rate than WPW syndrome and AVRT.
