Background: In the investigation of cardiac rhythm disorders, a normal electrophysiological (EPS) study is associated with a favorable prognosis. One of the normality criteria is established by conduction intervals within expected range.Objective: To establish reference values in EPS for the intracavitary conduction intervals (PA, AH and HV) in a Brazilian population.
Methods:A retrospective cohort study of the first 1,500 patients submitted to EPS ablation was performed at Instituto de Cardiologia do Rio Grande do Sul, Brazil. The EPS was considered normal if the test was performed for diagnostic purpose; absence of induced arrhythmias; and conduction intervals within the expected range. The REDCap software was used for data collection and management, and the SPSS Statistics 22.0 used for data analysis. Continuous variables were compared with Student's t-test for independent samples and categorical variables with the chi-square test (X 2 ). Values of p ≤ 0.05 were considered significant.Results: A total of 124 (8.3%) with EPS considered normal were included; mean age was 52 ± 21 years, and 63 were male. The mean values in milliseconds of PA, AH and HV were 23 ± 9, 88 ± 25 and 44 ± 7, respectively. The PA, AH, and HV percentile ranges were 13 -25, 81-107 and 40 -52, respectively. When the patients were divided into three age groups (1 to 18 years, 19 to 64 years and 65 or more), we observed that the group of older patients had significantly higher values of PA, AH and HV compared with younger patients.
Conclusion:This study showed that intracavitary conduction intervals in a sample of the Brazilian population were similar to previously published studies. Elderly patients tend to have higher values of intracavitary conduction intervals in EPS. Future studies including broader age ranges could enable the acquisition of more reliable and reproducible reference values.
BackgroundThe uninterrupted use of oral anticoagulation (OAC) with vitamin K
antagonists (VKAs) for electrophysiology procedures has been more and more
recommended. The clinical practice in our service recommends the continuous
use of these drugs for atrial flutter ablation. There is little evidence as
to the uninterrupted use of non-vitamin K antagonist oral anticoagulants
(NOACs) in this scenario.ObjectiveTo compare the rates of complications related with the uninterrupted use of
different types of oral anticoagulants in patients referred to atrial
flutter (AFL) ablation.MethodsHistorical, single-center cohort of ablation procedures by AFL conducted from
November 2012 to April 2016. The primary outcome was the occurrence of
hemorrhagic or embolic complication during the procedure. The secondary
outcome was the occurrence of stroke or transient ischemic attack (TIA) in
follow-up. The statistical significance level was 5%.ResultsThere were 288 ablations per AFL; 154 were carried out with the uninterrupted
use of OAC (57.8% with VKA and 42.2% with NOAC). Mean age was 57 ± 13
years. The rate of hemorrhagic complication during the procedure was 3% in
each group (p = NS). The rate of stroke/TIA was, respectively, of 56/1,000
people-year in the VKA group against zero/1,000 people-year in the NOAC
group (p = 0.02).ConclusionIn our population there were no hemorrhagic complications regarding the
procedure of OAC use uninterruptedly, including NOACs. There was higher
occurrence of stroke/TIA in the follow-up of the group of patients
undergoing VKAs; however, this difference may not only be a result of the
type of OAC used.
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