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. 2022 May;111(5):522-529.
doi: 10.1007/s00392-021-01878-z. Epub 2021 Jun 9.

Catheter ablation of supraventricular tachycardia in patients with and without structural heart disease: insights from the German ablation registry

Charlotte Eitel  1 , Hüseyin Ince  2 , Johannes Brachmann  3 , Karl-Heinz Kuck  4   5 , Stephan Willems  5   6 , Stefan G Spitzer  7 , Juergen Tebbenjohanns  8 , Leon Iden  9 , Florian Straube  10   11 , Matthias Hochadel  12 , Jochen Senges  12 , Roland R Tilz  4   5
Affiliations

Catheter ablation of supraventricular tachycardia in patients with and without structural heart disease: insights from the German ablation registry

Charlotte Eitel et al. Clin Res Cardiol. 2022 May.

Abstract

Aim: To compare patient characteristics, safety and efficacy of catheter ablation of supraventricular tachycardia (SVT) in patients with and without structural heart disease (SHD) enrolled in the German ablation registry.

Methods and results: From January 2007 until January 2010, a total of 12,536 patients (37.2% with known SHD) were enrolled and followed for at least one year. Patients with SHD more often underwent ablation for atrial flutter (45.8% vs. 20.9%, p < 0.001), whereas patients without SHD more often underwent ablation for atrioventricular nodal reentrant tachycardia (30.2% vs. 11.8%, p < 0.001) or atrioventricular reentrant tachycardia (9.1% vs. 1.6%, p < 0.001). Atrial fibrillation catheter ablation procedures were performed in a similar proportion of patients with and without SHD (38.1% vs. 36.9%, p = 0.21). Overall, periprocedural success rate was high in both groups. Death, myocardial infarction or stroke occurred in 0.2% and 0.1% of patients with and without SHD (p = 0.066). Major non-fatal complications prior to discharge were rare and did not differ significantly between patients with and without SHD (0.5% vs. 0.4%, p = 0.34). Kaplan-Meier mortality estimate at 1 year demonstrated a significant mortality increase in patients with SHD (2.6% versus 0.7%; p < 0.001).

Conclusion: Patients with and without SHD undergoing SVT ablation exhibit similar success rates and low major complication rates, despite disadvantageous baseline characteristics in SHD patients. These data highlight the safety and efficacy of SVT ablation in patients with and without SHD. Nevertheless Kaplan-Meier mortality estimates at 1 year demonstrate a significant mortality increase in patients with SHD, highlighting the importance of treating the underlying condition and reliable anticoagulation if indicated.

Keywords: Catheter ablation; Mortality/Survival; Quality and outcomes; Registry; Structural heart disease; Supraventricular tachycardia.

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Figures

Fig. 1
Fig. 1
Type of supraventricular tachycardia ablated in patients with and without structural heart disease. p < 0.001 for AVNRT, AVRT and atrial flutter. AVNRT: atrioventricular nodal reentrant tachycardia, AVRT: atrioventricular reentrant tachycardia
Fig. 2
Fig. 2
Percentage of supraventricular tachycardia ablation performed according to underlying heart disease. AF: atrial fibrillation, AF-AVN: atrial fibrillation—atrioventricular node ablation, Aflutter: atrial flutter, AT: atrial tachycardia, AVNRT: atrioventricular nodal reentrant tachycardia, AVRT: atrioventricular reentrant tachycardia
Fig. 3
Fig. 3
Change in symptoms following supraventricular tachycardia ablation according to underlying heart disease
Fig. 4
Fig. 4
Kaplan–Meier mortality estimate at 1 year demonstrated a significant mortality increase in patients with SHD (2.6% vs. 0.7%; p < 0.001)
See this image and copyright information in PMC

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