Clinical trial NCT05225662: Impact of Radiofrequency Ablation on Left Ventricular Function in Supraventricular Tachyarrhythmias Patient Using Speckle Tracking Echocardiography
Official title: A Study of the Impact of Radiofrequency Ablation on Left Ventricular Function in Supraventricular Tachyarrhythmias Patient Using Speckle Tracking Echocardiography
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Left Ventricular Function, Arrhythmia
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2022-02-04
Enrollment: 80
Sex: ALL
Maximum age (years): 70
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: all patient with supraventricular tachyarhythmia undergoing radiofrequency ablation

Brief summary: In this study, we aimed to evaluate atrial and ventricular function in supraventricular tachyarrhythmia patients before and 3 months after RFA using 2DSTE.

Detailed description: Two-dimensional speckle-tracking echocardiography (2DSTE) is a known technique for the evaluation of myocardial function in many conditions. The longitudinal deformation of the left ventricular (LV) mainly occurs in the subendocardial level which is sensitive to injury and it may be used to identify sub-clinical LV dysfunction in cardiomyopathies. Global longitudinal strain, strain rate (SR), and torsion measurements are very promising to identify patients with mild systolic and diastolic dysfunctions which are not reflected in reduced EF.

Tachyarrhythmias that are persistent and recurrent can lead to LV dysfunction. Dyssynchrony is another mechanism that may cause LV dysfunction, as in the case of Wolf Parkinson Syndrome (WPW ). It might be explained by the "collision" of electric stimuli through the normal atrioventricular conduction system and along the accessory pathway (AP) during the systolic phase. 2DSTE has been used to investigate the characteristics of WPW syndrome and confirm the presence of LV dyssynchrony in this condition.

Lelakowski et al. showed that RFA improves LV systolic and diastolic functions in patients with Atrioventricular Nodal Reentry tachycardia (AVNRT).

Recurrent AVNRT attacks increase atrial pressure, leading to elevated atrial wall stress, which causes negative remodeling and systolic impairment. It has been shown that left atrial(LA) functions improved after Radiofrequency ablation RFA, along with LA volume reduction in atrial fibrillation/flutter patients.

the small number of patients and lacking using advanced accurate techniques lead to currently insufficient data in the literature regarding changes in cardiac function following AVNRT \& AVRT ablation and whether LV dyssynchrony is reversible after ablation therapy of AVRT or not.

Eligibility criteria: Inclusion Criteria:

- Patients with AVNRT or AVRT undergoing RF ablation

Exclusion Criteria:

* - Patient with bundle blocks
* Coronary artery disease
* Diastolic dysfunction ≥grade 2
* Left ventricular hypertrophy
* Diabetes mellitus
* Chronic renal failure (GFR\<45ml\\min)
* Moderate to severe valvular heart disease
* Patient with bad echo window

Primary outcomes:
measure: left ventricular systolic function
timeFrame: baseline and 3 months later
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
citation: Nagai T, Hamabe A, Arakawa J, Tabata H, Nishioka T. The impact of left ventricular deformation and dyssynchrony on improvement of left ventricular ejection fraction following radiofrequency catheter ablation in Wolff-Parkinson-White syndrome: A comprehensive study by speckle tracking echocardiography. Echocardiography. 2017 Nov;34(11):1610-1616. doi: 10.1111/echo.13691. Epub 2017 Sep 19.
citation: Lelakowski J, Dreher A, Majewski J, Bednarek J, Pasowicz M. [Influence of the treatment of the atrioventricular reentry tachycardia by RF catheter ablation on the left ventricular systolic and diastolic function and exercise capacity]. Wiad Lek. 2009;62(2):71-80. Polish.