Ten Year Follow‐Up After Radiofrequency Catheter Ablation for Atrioventricular Nodal Reentrant Tachycardia in the Early Days Forever Cured, or a Source for New Arrhythmias?

Kimman, Geert-Jan; Bogaard, Margot D.; Hemel, Norbert M. van; Dessel, Pascal F.H.M. van; Jessurun, Emile R.; Boersma, Lucas V.A.; Wever, Eric F.D.; Theuns, Dominic; Jordaens, Luc

doi:10.1111/j.1540-8159.2005.00271.x

Cited by 32 publications

(36 citation statements)

References 16 publications

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“…In elderly patients, development of late AV block years after AVNRT ablation has been described. 29 Secondary arrhythmias, which might have been induced by atrial scarring after ablation, 30 were not observed among our patients. According to our findings, AVNRT ablation in pediatric patients was a safe procedure with no relevant late morbidity.…”

Section: Discussionmentioning

confidence: 87%

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Backhoff

Klehs

Müller

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Catheter ablation of the slow conducting pathway (SP) is treatment of choice for atrioventricular nodal reentrant tachycardia (AVNRT). Although there are abundant data on AVNRT ablation in adult patients, little is known about the long-term results ≥3 years after AVNRT ablation in pediatric patients. Methods and Results-Follow-up data from 241 patients aged ≤18 years who had undergone successful AVNRT ablation were analyzed. Median age at ablation had been 12.5 years, and median follow-up was 5.9 years. Radiofrequency current had been used in 168 patients (70%), whereas cryoenergy had been used in 73 patients (30%). Procedural end point of AVNRT ablation had been either SP ablation (no residual dual atrioventricular nodal physiology) or SP modulation (residual SP conduction allowing for a maximum of one atrial echo beat). After the initial AVNRT ablation, calculated freedom from AVNRT was 96% at 1 year, 94% at 3 years, 93% at 5 years, and 89% at 8 years. Age, sex, body weight, the choice of ablation energy, and the procedural end point of AVNRT ablation did not impact freedom from AVNRT. Six of 22 AVNRT recurrences (27%) occurred ≥5 years after ablation. No late complications including atrioventricular block were noted. Conclusions-Cumulatively, catheter ablation of AVNRT continued to be effective in >90% of our pediatric patients during the long-term course. A significant part of recurrences occurred >5 years post ablation. Body weight, energy source, and the end point of ablation had no impact on long-term results. No adverse sequelae were noted. (Circ Arrhythm Electrophysiol. 2016;9:e004264.

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Section: Discussionmentioning

confidence: 87%

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Backhoff

Klehs

Müller

et al. 2016

Circ: Arrhythmia and Electrophysiology

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“…Nevertheless, most patients indicate an improvement in quality of life after the ablation. It is well known that palpitations after AVNRT ablation often bear no relationship with the original arrhythmia: some patient complain of sinus tachycardia, atrial premature beats, ventricular premature beats or have an associated arrhythmia [3, 15]. Moreover, after AVNRT ablation atrial flutter might become present, or ectopic atrial tachycardia may arise due to the scarring [3].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that palpitations after AVNRT ablation often bear no relationship with the original arrhythmia: some patient complain of sinus tachycardia, atrial premature beats, ventricular premature beats or have an associated arrhythmia [3, 15]. Moreover, after AVNRT ablation atrial flutter might become present, or ectopic atrial tachycardia may arise due to the scarring [3]. It also has to be said when interpreting these results that atrial or ventricular premature beats, which often initiate AVNRT, are not treated by ablation of the slow pathway and may continue to provoke symptoms in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency (RF) catheter ablation is highly effective but carries the risk for creating inadvertent atrioventricular heart block (AVB). [3] Cryoablation (cryo) on the other hand can be performed very safely due to the possibility of ‘ice mapping’ and ‘cryoadherence’. [4] We showed in the past in a randomised trial that both techniques had the same acute outcome.…”

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up after catheter ablation for atrioventricular nodal reentrant tachycardia: a comparison of cryothermal and radiofrequency energy in a large series of patients

Schwagten¹,

Knops²,

Janse³

et al. 2010

J Interv Card Electrophysiol

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BackgroundRadiofrequency (RF) catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) is highly successful but carries a risk for inadvertent atrioventricular block. Cryoablation (cryo) has the potential to assess the safety of a site before the energy is applied.PurposeThe aim of this study was to evaluate the long-term efficacy and safety of cryothermal ablation in a large series of patients and compare it to RF.MethodsAll consecutive routinely performed AVNRT ablations from our centre between 1999 and 2007 were retrospectively analysed.ResultsIn total, 274 patients were elegible: 150 cryoablations and 124 RF. Overall procedural success was 96% (262/274), and equal in both groups, but nine patients were crossed to another arm. Mean fluoroscopy time was longer in the group treated with RF (27 ± 22 min vs. cryo 19 ± 15 min; p = 0.002). Mean procedure time was not different (RF 138 ± 71 min vs. cryo 146 ± 60 min). A permanent pacemaker was necessary in two RF patients. The questionnaire revealed a high incidence of late arrhythmia related symptoms (48%), similar in both groups, with improved perceived quality of life. The number of redo procedures for AVNRT over 4.3 ± 2.5-years follow-up was not statistically different (11% after cryo and 5% after RF).ConclusionsOur data confirm that cryo and RF ablation with 4-mm tip catheters for AVNRT are equally effective, even after long-term follow-up.

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“…Kimman et al (18) showed new types of recurrence of SVT after successful RFA in children. Similarly, Mujovic et al (19) reported new types of arrhythmia in 16% of 124 adult patients who underwent RFA for accessory pathways.…”

Section: Discussionmentioning

confidence: 99%

Is transesophageal electrophysiologic study valuable in children with successful radiofrequency ablation of supraventricular tachycardia on follow-up for recurrence?

Gülgün¹,

Özer²,

Karagöz³

et al. 2015

Anatol J Cardiol

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Objective:The aim of this study was to evaluate the efficacy of transesophageal electrophysiologic study (TEEPS) for the determination of supraventricular tachycardia (SVT) recurrences in symptomatic and asymptomatic children after successful radiofrequency ablation (RFA) for SVT.Methods:A total of 66 patients who underwent TEEPS after successful RFA were included. The demographic features, symptoms of the patients, and the characteristics of the recurrences induced by TEEPS were evaluated. The arrhythmia types induced during RFA were compared with those induced by TEEPS in terms of the compatibility of the diagnosis.Results:Forty-two (63.6%) girls and 24 (36.4%) boys with a mean age of 11.8±3.4 years were followed-up for 44.1±15.7 months. The average time between RFA and TEEPS was 5.2±5.9 months. The diagnoses during RFA were atrioventricular nodal reentrant tachycardia (AVNRT) in 47 of 66 patients, atrioventricular reentrant tachycardia (AVRT) in 18 of 66 patients, and ectopic atrial tachycardia in 1 of 66 patients. SVT was induced by TEEPS in 2 of 25 symptomatic and 5 of 41 asymptomatic patients. The SVT inducibility rate was 5.5% (1/18) and 12.7% (6/47) in patients with AVRT and AVNRT, respectively. In addition, 85.7% (6/7) of all recurrences occurred within 3.5 months. The recurrences as AVNRT in 2 of 25 symptomatic patients occurred in the first month after RFA. AVNRT in 4 of 41 and AVRT in 1 of 41 asymptomatic patients were induced within 3.5 months and 15 months, respectively.Conclusion:TEEPS seems to be a valuable screening and diagnostic method for the determination of recurrence in symptomatic and asymptomatic children who underwent successful RFA.

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Ten Year Follow‐Up After Radiofrequency Catheter Ablation for Atrioventricular Nodal Reentrant Tachycardia in the Early Days Forever Cured, or a Source for New Arrhythmias?

Cited by 32 publications

References 16 publications

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Long-Term Follow-Up After Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children

Long-term follow-up after catheter ablation for atrioventricular nodal reentrant tachycardia: a comparison of cryothermal and radiofrequency energy in a large series of patients

Is transesophageal electrophysiologic study valuable in children with successful radiofrequency ablation of supraventricular tachycardia on follow-up for recurrence?

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