Outcomes of ablation in Wolff-Parkinson-White-syndrome: Data from the German Ablation Registry
Autor: | Karl-Heinz Kuck, Stefan Kääb, Stephan Willems, Matthias Hochadel, Lars Eckardt, Johannes Brachmann, Johannes Brado, Jochen Senges, Moritz F. Sinner, Florian Straube, Dietrich Andresen, Thomas Deneke |
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Rok vydání: | 2021 |
Předmět: |
Male
Tachycardia medicine.medical_specialty medicine.medical_treatment Catheter ablation Accessory pathway 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine medicine Palpitations Humans Registries 030212 general & internal medicine Coronary sinus Medical treatment business.industry Ablation Accessory Atrioventricular Bundle Surgery Catheter Ablation Female Wolff-Parkinson-White Syndrome medicine.symptom Cardiology and Cardiovascular Medicine Complication business |
Zdroj: | International Journal of Cardiology. 323:106-112 |
ISSN: | 0167-5273 |
Popis: | Aims Catheter ablation is recommended for symptomatic WPW-syndrome. Commonly perceived low recurrence rates were challenged recently. We sought to identify patient strata at increased risk. Method Of 12,566 patients enrolled at 52 German Ablation Registry sites from 2007 to 2010, 789 were treated for WPW-syndrome. Patients were included for symptomatic palpitations and tachycardia documentation. Follow-up duration was one year. Overall complications were defined as serious, access-related, and ablation-related. We adjudicated WPW-recurrence for re-ablation during follow-up. Risk strata included: admission for repeat ablation at registry entry; accessory pathway localization; antiarrhythmic medical treatment before the ablation. Results WPW-syndrome patients were 42.8 ± 16.2 years on average; 39.9% were women. A majority of 95.9% was symptomatic; in 84.4%, a tachycardia was documented. Seventy-six (9.6%) patients presented for repeat procedures. Accessory pathways were located in the left atrium (71.4%), right atrium (21.1%), septum (4.4%), or coronary sinus diverticula (2.1%). Prior antiarrhythmic medication was used in 43.7% of patients. No serious events occurred. The overall complication rate was 2.5% (ablation related 1.2%, access-related 1.3%). Major determinants for complications were presentation for re-ablation as registry index procedure (6.9% vs 2.2%; p = 0.016) and septal pathway location (left 2.0% vs septal 9.1%, p = 0.014). The overall re-ablation rate was 9.7%. Usage of prior antiarrhythmic medication was associated with higher recurrence rates (12.2% vs. 7.6%; p = 0.035). Conclusions Patients at higher complication risk may be identified by repeat procedure and septal pathway location. Prior antiarrhythmic medication was associated with higher recurrence rates. Our findings may help improving peri-procedural patient management and information. |
Databáze: | OpenAIRE |
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