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Age at onset, gender distribution and intraarterial blood pressure changes in atrioventricular node-dependant
S S Kavthale1, B U Vajifdar, A M Naik
1Dept of Cardiology, King Edward VII Memorial Hospital, Mumbai.
Objective:
Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) utilising accessory pathways constitute the vast majority of paroxysmal supraventricular tachycardia (SVT). We studied the age at onset, the gender distribution and the intraarterial hemodynamics of these tachycardias.
Methods:
The data of 224 patients who underwent electrophysiology study (EPS) and radiofrequency ablation was analysed. The age at onset of tachycardia was assessed by a careful history. The intraarterial BP was noted during sinus rhythm (SR), immediately after tachycardia onset (T0) and 15 seconds after the onset of tachycardia (T15).
Results:
The age at onset of tachycardia was a decade later for AVNRT (48 +/- 10 years) than for AVRT (37 +/- 11 years). There was no gender preponderance in the AVNRT group (60 males, 56 females) while a male preponderance was seen in the AVRT group (71 males, 37 females, p < 0.01). There was a marked fall in the intraarterial systolic BP in both groups at the onset of tachycardia, from 143 +/- 24 mm Hg to 108 +/- 16 mm Hg (p < 0.05) for AVNRT and from 139 +/- 25 mm Hg to 107 +/- 18 mm Hg (p < 0.05) for AVRT. There was no correlation between the rate of tachycardia and the extent of fall of BP.
Conclusion:
Hospital-based data in an Indian setting found a similar pattern of age of onset of AV node-dependant tachycardia as in Western literature. However, unlike in Western studies, no female preponderance was seen in the AVNRT group. The fall in systolic BP at the onset of tachycardia is significant, similar in the two groups and independent of the rate of tachycardia.