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. 2024 Jul 14;5(8):538-542.
doi: 10.1016/j.hroo.2024.07.005. eCollection 2024 Aug.

Incidence of atrial fibrillation in patients with atrioventricular nodal re-entrant tachycardia and its association with long-term outcome

Gesa von Olshausen  1   2 , Nikola Drca  1   3 , Astrid Paul-Nordin  1   3 , Tara Bourke  1   3 , Hamid Bastani  1   3 , Serkan Saygi  1   3 , Emma Svennberg  1   3 , Finn Åkerström  1   3 , Ott Saluveer  1   3 , Mats Jensen-Urstad  1   3 , Frieder Braunschweig  1   3
Affiliations

Incidence of atrial fibrillation in patients with atrioventricular nodal re-entrant tachycardia and its association with long-term outcome

Gesa von Olshausen et al. Heart Rhythm O2. .

Abstract

Background: Atrioventricular nodal re-entrant tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. We sought to investigate the incidence of atrial fibrillation in patients with electrophysiologically confirmed/ablated AVNRT and its association with transient ischemic attack (TIA)/stroke as well as mortality during long-term follow-up.

Methods: From the Karolinska Ablation Registry, 2855 consecutive patients with a first-time ablation for AVNRT between 2005 and 2018 were analyzed.

Results: Patients were 52.1 ± 15.9 years old and 59.3% were women. During follow-up of up to 10 years (median 6.0 years; interquartile range 3.3 to 9.2 years), new onset or recurrence of atrial fibrillation occurred in 317 (11.1%) patients (incidence rate 19 cases per 1000 person-years). Excluding those with history of atrial fibrillation, new onset of atrial fibrillation occurred in 153 (6.1%) patients. In multivariable analysis, history of atrial fibrillation, arterial hypertension, history of TIA/stroke, and heart failure remained independently associated with new onset or recurrence of atrial fibrillation during follow-up. Death of any cause and TIA/stroke occurred in 141 (4.9%) patients and 107 (3.7%) patients, respectively. In multivariable analysis, occurrence of atrial fibrillation during follow-up remained independently associated with both outcomes. The prevalence of atrial fibrillation according to age at the end of follow-up was high among young patients (<60 years of age: 12.7%; 60-69 years of age: 10.6%).

Conclusion: In this large cohort of patients with diagnosed AVNRT, the incidence of atrial fibrillation was high (11.1%) during long-term follow-up. Occurrence of atrial fibrillation during follow-up remained independently associated with death for any cause as well as with TIA/stroke. Therefore, a closer monitoring for atrial fibrillation in patients with AVNRT including those at young age is advisable.

Keywords: Atrial fibrillation; Atrioventricular nodal re-entrant tachycardia; Catheter ablation; Catheter ablation registry; Recurrence.

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Figures

Figure 1
Figure 1
Kaplan–Meier analysis of event-free survival from atrial fibrillation after 10 year follow-up.
See this image and copyright information in PMC

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