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Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts

BACKGROUND: The prevalence of ventriculo-atrial (VA) conduction varies from 20% to 90%, depending on the population studied (Militianu et al., 1997; Inoue et al., 1985; Kazmierczak et al., 1993; Ciemniewski et al., 1990; Hayes and Furman, 1983; Westveer et al., 1984). This wide range is mostly based...

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Autores principales: Patil, Ganesh, Phadke, Milind, Lokhandwala, Yash, Shaikh, Zohaib, Nathani, Pratap, Mahajan, Ajay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485403/
https://www.ncbi.nlm.nih.gov/pubmed/28648420
http://dx.doi.org/10.1016/j.ihj.2016.12.008
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author Patil, Ganesh
Phadke, Milind
Lokhandwala, Yash
Shaikh, Zohaib
Nathani, Pratap
Mahajan, Ajay
author_facet Patil, Ganesh
Phadke, Milind
Lokhandwala, Yash
Shaikh, Zohaib
Nathani, Pratap
Mahajan, Ajay
author_sort Patil, Ganesh
collection PubMed
description BACKGROUND: The prevalence of ventriculo-atrial (VA) conduction varies from 20% to 90%, depending on the population studied (Militianu et al., 1997; Inoue et al., 1985; Kazmierczak et al., 1993; Ciemniewski et al., 1990; Hayes and Furman, 1983; Westveer et al., 1984). This wide range is mostly based on studies done in patients with implanted devices or impaired atrioventricular conduction. However, the prevalence of VA conduction in structurally normal heart has not been well documented till date. OBJECTIVE: To study the prevalence and identify predictors of retrograde conduction via the His-Purkinje system and AV node in structurally normal hearts. METHODS: We included 54 consecutive adults without structural heart disease who underwent electrophysiological (EP) study for various tachycardias. The basic parameters including PR, AH and HV intervals, atrioventricular Wenckebach point (AVWP) and anterograde effective refractory period (ERP) of atrioventricular node (AVNERP), were measured after ablation. The VA conduction was assessed basally and if absent, after isoprenaline. The VA Wenckebach point (VAWP) and retrograde ERP(VAERP) were recorded in patients showing VA conduction. RESULTS: The mean age was 37.1 ± 12.6years. Twenty five (46%) of the patients were men. VA conduction was present in 30 (55%) patients at baseline. Of the remaining 24 patients, 18 (34%) showed VA conduction after isoprenaline. Only 6 (11%) patients failed to reveal VA conduction even after adequate response to isoprenaline. Amongst all clinical and EP variables analysed, only the HV interval was shorter (p < 0.01) in patients with VA conduction. CONCLUSION: In structurally normal hearts, VA conduction was present at baseline in 55% of patients. Isoprenaline unmasked VA conduction in an additional 34% of the subjects. The HV interval was longer in patients without VA conduction.
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spelling pubmed-54854032018-05-01 Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts Patil, Ganesh Phadke, Milind Lokhandwala, Yash Shaikh, Zohaib Nathani, Pratap Mahajan, Ajay Indian Heart J Original Article BACKGROUND: The prevalence of ventriculo-atrial (VA) conduction varies from 20% to 90%, depending on the population studied (Militianu et al., 1997; Inoue et al., 1985; Kazmierczak et al., 1993; Ciemniewski et al., 1990; Hayes and Furman, 1983; Westveer et al., 1984). This wide range is mostly based on studies done in patients with implanted devices or impaired atrioventricular conduction. However, the prevalence of VA conduction in structurally normal heart has not been well documented till date. OBJECTIVE: To study the prevalence and identify predictors of retrograde conduction via the His-Purkinje system and AV node in structurally normal hearts. METHODS: We included 54 consecutive adults without structural heart disease who underwent electrophysiological (EP) study for various tachycardias. The basic parameters including PR, AH and HV intervals, atrioventricular Wenckebach point (AVWP) and anterograde effective refractory period (ERP) of atrioventricular node (AVNERP), were measured after ablation. The VA conduction was assessed basally and if absent, after isoprenaline. The VA Wenckebach point (VAWP) and retrograde ERP(VAERP) were recorded in patients showing VA conduction. RESULTS: The mean age was 37.1 ± 12.6years. Twenty five (46%) of the patients were men. VA conduction was present in 30 (55%) patients at baseline. Of the remaining 24 patients, 18 (34%) showed VA conduction after isoprenaline. Only 6 (11%) patients failed to reveal VA conduction even after adequate response to isoprenaline. Amongst all clinical and EP variables analysed, only the HV interval was shorter (p < 0.01) in patients with VA conduction. CONCLUSION: In structurally normal hearts, VA conduction was present at baseline in 55% of patients. Isoprenaline unmasked VA conduction in an additional 34% of the subjects. The HV interval was longer in patients without VA conduction. Elsevier 2017 2016-12-21 /pmc/articles/PMC5485403/ /pubmed/28648420 http://dx.doi.org/10.1016/j.ihj.2016.12.008 Text en © 2016 Published by Elsevier B.V. on behalf of Cardiological Society of India. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Patil, Ganesh
Phadke, Milind
Lokhandwala, Yash
Shaikh, Zohaib
Nathani, Pratap
Mahajan, Ajay
Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title_full Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title_fullStr Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title_full_unstemmed Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title_short Prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
title_sort prevalence and predictors of ventriculo-atrial conduction in structurally normal hearts
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485403/
https://www.ncbi.nlm.nih.gov/pubmed/28648420
http://dx.doi.org/10.1016/j.ihj.2016.12.008
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