Long-term symptom improvement and patient satisfaction following catheter ablation of supraventricular tachycardia: insights from the German ablation registry

Abstract

Ablation therapy for SVT is a safe procedure bringing symptomatic improvement and satisfaction to three quarters of patients after 1 year. Even in patients with arrhythmia recurrence, a high satisfaction level and adherence to the ablating institution could be documented. Strikingly high mortality and stroke rates in follow-up were observed in AFL patients, who apparently need consistent long-term anticoagulation and more medical attention.

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: What is the best practice?

“…Cognitive outcomes between those patients that received an ablation were similar to patients without a history of AF, including all subtypes of dementia. In patients with atrial flutter stroke rates post‐ablation are significantly lower compared with AF patients treated with ablation . However, as these were not RCTs, better outcomes could have been related to selection bias rather than impact of ablation.…”

“…In patients with atrial flutter stroke rates post-ablation are significantly lower compared with AF patients treated with ablation. 169 However, as these were not RCTs, better outcomes could have been related to selection bias rather than impact of ablation.…”

“…Procedural risk with all cardiac left sided procedures may impact long‐term cognition due to the presence of peri‐procedural thrombus, atheroemboli, cerebral hypoperfusion, sheath and wire manipulation and management, and anaesthesia. In patients that undergo right sided cardiac procedures the risk is anticipated to be lower although paradoxical thromboembolism can occur in the presence of a septal defect . The risk of stroke during left atrial catheter ablation is estimated at approximately 0.5‐1% .…”

“…In patients that undergo right sided cardiac procedures the risk is anticipated to be lower although paradoxical thromboembolism can occur in the presence of a septal defect. 169 The risk of stroke during left atrial catheter ablation is estimated at approximately 0.5-1%. 121 However asymptomatic or subclinical ischaemic lesions develop in up to 41% of AF ablation patients with an incidence that varies with anticoagulation approach, ablation tool used, and cranial scan protocol.…”

Progress in the management of arrhythmias: risk scores, ablation, and anticoagulation

“…In particular, catheter-based ablation made certain supraventricular arrhythmias such as atrioventricular reentrant tachcardia, among others, curable-a rare outcome in cardiovascular medicine. 6 In addition, while most antiarrhythmic drugs proved ineffective or dangerous in patients with ventricular arrhythmias, modern implantable cardioverter defibrillators are important tools in the prevention of sudden cardiac death. Further progress in this field is summarized in 'The year in Cardiology 2017: arrhythmia and cardiac devices' authored by Jan Steffel from the University of Zurich in Switzerland and Cecilia Linde from the Karolinska Hospital in Stockholm, Sweden.…”