Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia.

Telishevska, Marta; Lengauer, Sarah; Reents, Tilko; Kantenwein, Verena; Popa, Miruna; Bahlke, Fabian; Englert, Florian; Erhard, Nico; Deisenhofer, Isabel; Hessling, Gabriele

doi:10.3390/jcm12206532

Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)

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Document type:: Journal Article
Author(s):: Telishevska, Marta; Lengauer, Sarah; Reents, Tilko; Kantenwein, Verena; Popa, Miruna; Bahlke, Fabian; Englert, Florian; Erhard, Nico; Deisenhofer, Isabel; Hessling, Gabriele
Title:: Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia.
Abstract:: BACKGROUND: The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP). METHODS: A retrospective single-center review of patients who underwent ESP ablation between December 2014 and September 2022 was performed. Follow-up included telephone communication, letter questionnaire and outpatient presentation. Recurrence was based on typical symptoms. RESULTS: 115 patients aged 6-81 years (median age 36.3 years, 59.1% female; 26 pts < 18 years) were included. A typical history was present in all patients (100%), an ECG documentation of narrow complex tachycardia in 97 patients (84%). Patients were divided into three groups: Group 1 without DAVNP (n = 23), Group 2 with AH jump (n = 30) and Group 3 with AH jump and at least one AV nodal echo beat (n = 62). No permanent AV block was observed. During a median follow-up of 23.6 ± 22.7 months, symptom recurrence occurred in 7/115 patients (6.1%) with no significant difference between the groups (p = 0.73, log-rank test). Symptom recurrence occurred significantly more often in patients without (5/18 patients; 27%) as compared to patients with ECG documentation (2/97 patients; 2.1%; p = 0.025). No correlation between age and success rate was found (p > 0.1). CONCLUSIONS: ESP ablation is effective and safe in patients with non-inducible AVNRT. Overall, recurrence of symptoms during long-term follow-up is low, even if no DAVNP is present. Tachycardia documentation before the EP study leads to a significantly lower recurrence rate following ESP ablation.
Journal title abbreviation:: J Clin Med
Year:: 2023
Journal volume:: 12
Journal issue:: 20
Fulltext / DOI:: doi:10.3390/jcm12206532
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/37892670
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2023