Outcomes of supraventricular tachycardia ablation: Results from the Singapore ablation and cardiac devices registry.

Autor: Tan ESJ; Department of Cardiology, National University Heart Centre, Singapore, Singapore.; Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore., Chan SP; Department of Cardiology, National University Heart Centre, Singapore, Singapore.; Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore., Seow SC; Department of Cardiology, National University Heart Centre, Singapore, Singapore.; Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore., Teo WS; Department of Cardiology, National Heart Centre, Singapore, Singapore., Ching CK; Department of Cardiology, National Heart Centre, Singapore, Singapore., Chong DTT; Department of Cardiology, National Heart Centre, Singapore, Singapore.; Duke-NUS Graduate Medical School, Singapore, Singapore., Tan VH; Department of Cardiology, Changi General Hospital, Singapore, Singapore., Chia PL; Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore., Foo DCG; Department of Cardiology, Tan Tock Seng Hospital, Singapore, Singapore., Kojodjojo P; Department of Cardiology, National University Heart Centre, Singapore, Singapore.; Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.; Department of Cardiology, Ng Teng Fong General Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2022 Jan; Vol. 45 (1), pp. 50-58. Date of Electronic Publication: 2021 Dec 08.
DOI: 10.1111/pace.14410
Abstrakt: Background: The Singapore Cardiac Databank was designed to monitor the performance and outcomes of catheter ablation. We investigated the outcomes of paroxysmal supraventricular tachycardia (PSVT)-ablation in a prospective, nationwide, cohort study.
Methods: Atrioventricular nodal re-entrant tachycardia (AVNRT), atrioventricular re-entry tachycardia (AVRT), or atrial tachycardia (AT)-ablations in Singapore from 2010 to 2018 were studied. Outcomes include acute success, periprocedural-complications, postoperative pacing requirement, arrhythmic recurrence and 1-year all-cause mortality.
Results: Among 2260 patients (mean age 45 ± 18 years, 50% female, 57% AVNRT, 37% AVRT, 6% AT), overall acute success rates of PSVT-ablation was 98.4% and increased in order of AT, AVRT, and AVNRT (p < .001). Periprocedural cardiac tamponade occurred in two AVRT patients. A total of 15 pacemakers (6 within first 30-days, 9 after 30-days) were implanted (seven AV block, eight sinus node dysfunction [SND]), with the highest incidence of pacemaker implantation after AT-ablation (5% vs. 0.6% AVNRT vs. 0.1% AVRT, p < .001). Repeat ablations (0.9% AVNRT, 7% AVRT, 4% AT, p < .001) were performed in 78 (3.5%) patients and 13 (0.6%) patients died within a year of ablation. Among outcomes considered adjusting for age, sex, PSVT-type and procedure-time, AT was independently associated with 6-fold increased odds of total (adjusted odds ratio [AOR] 6.32, 95% confidence interval [CI] 1.95-20.53) and late (AOR 6.38, 95% CI 1.39-29.29) pacemaker implantation, while AVRT was associated with higher arrhythmic recurrence with repeat ablations (AOR 4.72, 95% CI 2.36-9.44) compared to AVNRT.
Conclusions: Contemporary PSVT ablation is safe with high acute success rates. Long-term outcomes differed by nature of the PSVT.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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