{"title":"His 束位置和方向对消融疗效和安全性的影响。","authors":"Bangjiaxin Ren, Ying Cao, Jing Li, Fanghui Li, Chuanyun Wang, Meng Xiao, Xianjin Hu, Rui Zeng","doi":"10.1111/pace.15053","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (D<sub>HIS-ABL</sub>) affects ablation safety and efficacy.</p><p><strong>Methods: </strong>Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (D<sub>His-CS</sub>), the height of the His bundle (H<sub>HIS</sub>), and D<sub>HIS-ABL</sub> were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications.</p><p><strong>Results: </strong>Multiple linear regression showed that H<sub>HIS</sub> was negatively correlated with age in both groups. In AVNRT patients, D<sub>HIS-ABL</sub> was associated with age, height, and BMI; D<sub>HIS-CS</sub> was only negatively correlated with age. In AVRT patients, there was no significant correlation between the D<sub>HIS-ABL</sub> and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with D<sub>HIS-ABL</sub> ≤ 10 mm had a higher recurrence rate than those with D<sub>HIS-ABL </sub>> 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%.</p><p><strong>Conclusions: </strong>H<sub>HIS</sub> was negatively correlated with age but not with height and BMI. The D<sub>HIS-ABL</sub> correlated with age, height, and BMI in AVNRT patients. A short D<sub>HIS-ABL</sub> led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The impact of His bundle location and direction on the efficacy and safety of ablation.\",\"authors\":\"Bangjiaxin Ren, Ying Cao, Jing Li, Fanghui Li, Chuanyun Wang, Meng Xiao, Xianjin Hu, Rui Zeng\",\"doi\":\"10.1111/pace.15053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (D<sub>HIS-ABL</sub>) affects ablation safety and efficacy.</p><p><strong>Methods: </strong>Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (D<sub>His-CS</sub>), the height of the His bundle (H<sub>HIS</sub>), and D<sub>HIS-ABL</sub> were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications.</p><p><strong>Results: </strong>Multiple linear regression showed that H<sub>HIS</sub> was negatively correlated with age in both groups. In AVNRT patients, D<sub>HIS-ABL</sub> was associated with age, height, and BMI; D<sub>HIS-CS</sub> was only negatively correlated with age. In AVRT patients, there was no significant correlation between the D<sub>HIS-ABL</sub> and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with D<sub>HIS-ABL</sub> ≤ 10 mm had a higher recurrence rate than those with D<sub>HIS-ABL </sub>> 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%.</p><p><strong>Conclusions: </strong>H<sub>HIS</sub> was negatively correlated with age but not with height and BMI. The D<sub>HIS-ABL</sub> correlated with age, height, and BMI in AVNRT patients. A short D<sub>HIS-ABL</sub> led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.</p>\",\"PeriodicalId\":54653,\"journal\":{\"name\":\"Pace-Pacing and Clinical Electrophysiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pace-Pacing and Clinical Electrophysiology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.15053\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15053","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
The impact of His bundle location and direction on the efficacy and safety of ablation.
Background: The impact of the His bundle location and distance from the ablation site on ablation efficacy and complication risk remains unexplored. We determined the correlation between age, height, body mass index (BMI), and the His bundle location, and whether the distance between the His bundle and ablation target (DHIS-ABL) affects ablation safety and efficacy.
Methods: Overall, 346 patients with atrioventricular nodal re-entrant tachycardia (AVNRT) and 96 with atrioventricular re-entrant tachycardia (AVRT) were retrospectively analyzed. The distance between the His bundle and the coronary sinus ostium (DHis-CS), the height of the His bundle (HHIS), and DHIS-ABL were measured. Electrocardiograms were obtained 3 months post-ablation to assess recurrence and complications.
Results: Multiple linear regression showed that HHIS was negatively correlated with age in both groups. In AVNRT patients, DHIS-ABL was associated with age, height, and BMI; DHIS-CS was only negatively correlated with age. In AVRT patients, there was no significant correlation between the DHIS-ABL and age, height, or BMI. The recurrence rates in the AVNRT and AVRT groups were 0.9% and 8.7%, respectively. Subgroup analysis showed that patients with DHIS-ABL ≤ 10 mm had a higher recurrence rate than those with DHIS-ABL > 10 mm (p = .013). The incidence of third-degree atrioventricular block (AVB) complications was 0.2%.
Conclusions: HHIS was negatively correlated with age but not with height and BMI. The DHIS-ABL correlated with age, height, and BMI in AVNRT patients. A short DHIS-ABL led to a higher rate of supraventricular tachycardia recurrence; whether this affects AVB risk warrants further studies with larger sample sizes.
期刊介绍：
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.
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