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Comparaison des études électrophysiologiques transoesophagienne et endocavitaire dans l’évaluation pronostique des syndromes de préexcitation ventriculaire

Abstract : BACKGROUND: Preexcitation syndrome (PS) is a potential cause of sudden cardiacdeath (SCD). Its prognostic assessment is therefore a major issue.OBJECTIVE: The aim of our study was to assess the prognostic performance oftransesophageal electrophysiological study (EPS) compared to intracardiac EPS in PS.METHODS: Any patient referred to the University Hospital of Nancy, France between2008 and 2014, who underwent both transesophageal and intracardiac EPS for a PS,was prospectively included. The endpoints were the measurement of accessory pathway effective refractory period (AP ERP) (risk of SCD when ? 250ms at baseline or ? 200 on isoproterenol) and the induction of sustained supraventricular tachyarrhythmias (SVTs).RESULTS: 69 patients were included (mean age 31 years, males 65%). AP ERPs weresignificantly shorter at transesophageal EPS compared to intracardiac EPS, whether it isat baseline (268ms versus 304ms, p=0.002) or on isoproterenol (229ms versus 281ms,p=0.010). There was no significant difference in the induction of SVTs. The sensitivity of transesophageal EPS in prognostic assessment was 88% at baseline and 100% onisoproterenol. The area under ROC curve predicting the prognostic performance oftransesophageal EPS was 0.74. 49% of patients had a shorter AP ERP (? 40ms ofdifference) at transesophageal EPS compared to intracardiac EPS at baseline. AP ERPdecreased significantly less on isoproterenol at transesophageal EPS in these patientscompared to the other 51% of patients with similar AP ERPs (29ms versus 50ms,p=0.042).CONCLUSION: Transesophageal EPS is a reliable and sensitive method of prognosticassessment in patients with PS. There might be an increased adrenergic factor due tostress during transesophageal EPS
Document type :
Master thesis
File URL :
http://docnum.univ-lorraine.fr/prive/BUMED_T_2015_VINCENT_JULIE.pdf
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https://hal.univ-lorraine.fr/hal-01770655
Contributor : Colette Orange <>
Submitted on : Thursday, April 19, 2018 - 10:56:41 AM
Last modification on : Thursday, April 19, 2018 - 10:56:41 AM

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  • HAL Id : hal-01770655, version 1

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Julie Vincent. Comparaison des études électrophysiologiques transoesophagienne et endocavitaire dans l’évaluation pronostique des syndromes de préexcitation ventriculaire. Sciences du Vivant [q-bio]. 2015. ⟨hal-01770655⟩

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