| AIM Atrioventricular nodal reentrant tachycardia is the most commen form of paroxysmal supraventricular tachycardia, which has a predominance in women before 40 years. Most of Atrioventricular nodal reentrant tachycardia patients have no structural heart disease. Our aim is to observe electrophysiological parameters in patients with slow-fast atrioventricular nodal reentrant tachycardia and study their relations between age,the presence of structural heart disease and gender, so we can offer new epidemiology data of AVNRT for clinical treatment.Methord The study group consisted of 124 patients with slow-fast AVNRT, who underwent slow pathway modification in our hospital between march 2008 and may 2009.There are 44 men and 80 women, age 11~75(45±15) years. These patients was performed slow pathway radiofrequency ablation to observe the extent of gender differences in electrophysiological parameters: age at onset,the presence of structural heart disease,the methods of tachycardia induction (isoproterenol),fast pathway ERP,slow pathway ERP,AH internal,tachycardia cycle length. After operation, we compare their acute success rate,recurrence and endpoints of atrioventricular nodal reentrant tachycardia and study their relations between age,the presence of structural heart disease and gender.Result There are no render difference in age at onset ( 38±12.0 vs 36±13.5 year,P>0.05),the methods of tachycardia induction (isoproterenol) (21.35% vs 22.7% , P > 0.05),acute success rate (98% vs 99% , P > 0.05) and recurrences(2.3% vs 2.5%,P>0.05) among them. 75.9% of women's slow pathways completely disappeared, 81.4% of men's slow way completely disappeared. There no difference between them. Men had a greater incidence of associated structural heart disease(13.6% vs 10%). In patients with structural heart disease, the onset of symptoms occurred at significantly older age compared with patients without heart disease[(34±12.6)years vs (53±7.9)years,P<0.001;(36±11.6)years vs (47±10.3)years,P<0.05]. 4 of 124 patients` age were younger than fifteen years old, which were all women. Sinus cycle length,fast pathway effective refractory period,AH internal and achycardia cycle length were smaller in children who were younger than fifteen years old, but the difference had no significant. Slow pathway effective refractory period was significant smaller in children who were younger than fifteen years old [(218±19.6)ms vs (241±31.0)ms,P<0.05]. Sinus cycle length [(782±110)ms vs (830±121)ms,P<0.05], slow pathway effective refractory period (240±37)ms vs (285±37)ms,P<0.01), and tachycardia cycle length [(341±52)ms vs (364±76)ms,P<0.05] were shorter in women. No gender differences were noted in fast pathway effective refractory period and AH internal ([328±50)ms vs (335±37)ms, P>0.05; (113±58)ms vs (122±92)ms P > 0.05]. We further compared slow pathway effective refractory period between menopausal women, premenopausal women and men.slow pathway effective refractory period was longer in men than in menopausal women [ ( 285±37.3 ) ms vs ( 235±26.5 ) ms , P < 0.05] and premenopausal women([285±37.3)ms:(242±41.7ms),P<0.05]. No differences were observed between menopausal and premenopausal women.Conclusion AV nodal ERP of Adult were bigger than them of children. In patients with structural heart disease, the onset of symptoms occurred at significantly older age compared with patients without heart disease, suggesting that the change of AV nodal may decided that people who had double atrioventricular node pathways occurred AVNRT sooner or later, the pathophysiologic mechanism may depend on the underlying cardiac substrate. Women have shorter slow pathway refractory periods, sinus cycle length and tachycardia cycle lengths. There were no gender difference were found in the fast pathway effective refractory period. Therefore, women have a wider"tachycardia window", a finding that may explain the reason why women have a greater incidence of AVNRT than men. |
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