TY - JOUR
T1 - Long-term safety and efficacy of supraventricular tachycardia ablation with a simplified approach
AU - Pellegrino, Pier Luigi
AU - Grimaldi, Massimo
AU - Di Martino, Luigi
AU - Caivano, Marica
AU - Santoro, Francesco
AU - di Biase, Luigi
AU - Di Biase, Matteo
AU - Brunetti, Natale Daniele
N1 - Publisher Copyright:
© 2016, Acta Cardiologica. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Introduction Catheter-ablation (CA) is routinely used for the treatment of atrio-ventricular nodal re-entrant tachycardia (AVNRT) and accessory AV-pathways and is usually performed with 4 or 5 catheters. This study reports the short- and long-term results of an alternative simplified approach with a 2-catheter configuration for both electrophysiological study (EPS) and CA in patients with re-entrant supraventricular tachycardias. Methods In total, 274 consecutive patients who underwent EPS with a view to curative CA for AVNRT or AVRT were enrolled. A 2-catheter configuration was routinely used. Ablation success, acute in-hospital complications, symptoms recurrence, arrhythmia recurrence were recorded. Results 195 patients underwent ablation of AVNRT and 79 of a single AP. Immediate success after CA ablation was achieved in 99.6% of patients. Major complications occurred in 2 patients (0.73%, 2 cases of complete AV block, one of which requiring pacemaker implantation after 1 year, one during typical AVNRT ablation and one during epicardial AP-ablation). Vascular complications occurred in 4 patients (1.4%, 3 partial femoral vein thrombosis without embolic events, one femoral arteriovenous fistula). Minimal pericardial effusion occurred in 6 patients (2.2%). All vascular complications were medically successfully treated not requiring surgery. The mean follow-up was 86 months. Arrhythmia recurrence was observed in 5.6% of patients (2.6% with AP, 2.9% with AVNRT); a second successful catheter ablation was performed in 2.9%. Conclusions CA with simplified approach is effective in the treatment of supraventricular tachycardia due to APs and AVNRT and is associated with a low incidence of major and minor complications and late recurrence of arrhythmias.
AB - Introduction Catheter-ablation (CA) is routinely used for the treatment of atrio-ventricular nodal re-entrant tachycardia (AVNRT) and accessory AV-pathways and is usually performed with 4 or 5 catheters. This study reports the short- and long-term results of an alternative simplified approach with a 2-catheter configuration for both electrophysiological study (EPS) and CA in patients with re-entrant supraventricular tachycardias. Methods In total, 274 consecutive patients who underwent EPS with a view to curative CA for AVNRT or AVRT were enrolled. A 2-catheter configuration was routinely used. Ablation success, acute in-hospital complications, symptoms recurrence, arrhythmia recurrence were recorded. Results 195 patients underwent ablation of AVNRT and 79 of a single AP. Immediate success after CA ablation was achieved in 99.6% of patients. Major complications occurred in 2 patients (0.73%, 2 cases of complete AV block, one of which requiring pacemaker implantation after 1 year, one during typical AVNRT ablation and one during epicardial AP-ablation). Vascular complications occurred in 4 patients (1.4%, 3 partial femoral vein thrombosis without embolic events, one femoral arteriovenous fistula). Minimal pericardial effusion occurred in 6 patients (2.2%). All vascular complications were medically successfully treated not requiring surgery. The mean follow-up was 86 months. Arrhythmia recurrence was observed in 5.6% of patients (2.6% with AP, 2.9% with AVNRT); a second successful catheter ablation was performed in 2.9%. Conclusions CA with simplified approach is effective in the treatment of supraventricular tachycardia due to APs and AVNRT and is associated with a low incidence of major and minor complications and late recurrence of arrhythmias.
KW - Radiofrequency catheter ablation
KW - Simplified 2-catheter approach
KW - Supraventricular tachycardia
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U2 - 10.2143/AC.71.6.3178192
DO - 10.2143/AC.71.6.3178192
M3 - Article
C2 - 27920461
AN - SCOPUS:85003481228
SN - 0001-5385
VL - 71
SP - 724
EP - 729
JO - Acta Cardiologica
JF - Acta Cardiologica
IS - 6
ER -