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

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.

Sex and racial disparities in catheter ablation

“… 29 In a German registry, the reported rates differed significantly between subgroups with structural heart disease (26% female) and patients with structural normal heart (46% female). 30 Reported acute success rates of atrial flutter ablation, including both typical and atypical flutters, was 96%, with a long-term success rate of 71%. 27 Success rates were similar between men and women.…”

Acute and mid-term outcomes of ablation for atrial fibrillation with VISITAG SURPOINT: the Japan MIYABI registry

“…Radiofrequency (RF) catheter ablation provides excellent results for treating many types of supraventricular arrhythmias. 1 Electrical isolation of the pulmonary veins (PVs) from the left atrium is the cornerstone of all AF ablation procedures. 2 The creation of durable lesions during PV isolation (PVI) for AF is of critical importance for preventing late PV reconnection and subsequent recurrence of arrhythmia.…”