Journal of Cardiovascular Pharmacology and Therapeutics

 

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Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 12, No. 2, 137-144 (2007)
DOI: 10.1177/1074248407300775

Role of Coronary Angiography Before Radiofrequency Ablation in Patients Presenting With Paroxysmal Supraventricular Tachycardia

Marc Dorenkamp, MD

Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin

Markus Zabel, MD

Department of Cardiology and Pneumology, Georg-August-Universität, Göttingen, Germany

Christian Sticherling, MD

Division of Cardiology, University Hospital Basel, Switzerland, csticherling{at}uhbs.ch

During episodes of paroxysmal supraventricular tachycardia (PSVT), electrocardiograms frequently show ST-segment depressions, and patients may experience typical chest pain prompting invasive coronary angiography. We evaluated 114 patients presenting with PSVT for concomitant coronary artery disease (CAD). Patients were classified as to the type of PSVT, symptoms during PSVT, and cardiovascular risk factors. Maximum heart rate, extent of ST-segment depression, and cardiac troponin levels during PSVT were recorded. Patients were subjected to exercise testing and/or coronary angiography. During PSVT, symptoms suggestive of myocardial ischemia, including chest pain (31%), ST-segment depression (61%), and elevated troponin levels (12%), were common. Sixty-seven patients (59%) underwent coronary angiography. The overall prevalence of significant CAD was found to be low (4%) and did not correlate to symptoms during tachycardia. Routine coronary angiography cannot be recommended in patients with PSVT unless routine evaluation outside episodes of tachycardia suggests the presence of significant CAD.

Key Words: paroxysmal supraventricular tachycardia • radiofrequency ablation • coronary angiography • ST-segment depression • cardiac troponin


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