Long-term efficacy of empirical slow pathway ablation in non-inducible and suspected atrioventricular nodal reentry tachycardia

J. He; Z. Liu; P.-H. Fang; X.-B. Chen; J. Liu; M. Tang; Y.-H. Jia; S. Zhang

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Document Details :

Title: Long-term efficacy of empirical slow pathway ablation in non-inducible and suspected atrioventricular nodal reentry tachycardia
Author(s): J. He , Z. Liu , P.-H. Fang , X.-B. Chen , J. Liu , M. Tang , Y.-H. Jia , S. Zhang
Journal: Acta Cardiologica
Volume: 71 Issue: 4 Date: 2016
Pages: 457-462
DOI: 10.2143/AC.71.4.3159699

Abstract :
Background: The empirical slow pathway ablation (ESPA) is often applied to non-inducible and suspected atrioventricular nodal reentrant tachycardia (AVNRT) patients. The long-term efficacy of ESPA in these patients is not entirely clear.
Methods: From January 2005 through December 2013, all patients who underwent slow pathway ablation were evaluated. Based on whether AVNRT could be induced, patients were divided into group A (AVNRT inducible) and group B (AVNRT non-inducible). Telephone communication, letter questionnaire and clinic visit were conducted for long-term follow-up, Recurrence was based on symptoms and/or ECG documentation.
Results: 622 patients underwent slow pathway ablation (median age 48 years, 56.8% female) were included in the study. 488 patients were classified into group A and 134 patients into group B. In a median follow-up of 31 months, the recurrence rate was similar between group A (7.4%) and group B (9.0%) (P > 0.05), the recurrence rate due to supraventricular tachycardia (SVT) and other arrhythmias was also similar between the groups (P > 0.05). In group B, the recurrence rate of patients without tachycardia ECG documentation before ablation was higher than those with tachycardia ECG documentation (P = 0.033). Logistic regression analysis showed that no tachycardia ECG documentation before ablation was a significant prognostic predictor for recurrence (P = 0.019). One major complication occurred in group A and none in group B.
Conclusion: ESPA can be performed safely and effectively in non-inducible and suspected AVNRT patients with good long-term results, no tachycardia ECG documentation before ablation is predictive for recurrence in these patients.