Long-term safety and efficacy of supraventricular tachycardia ablation with a simplified approach

Abstract

Introduction Catheter-ablation (CA) is routinely used for the treatment of atrio-ventricular nodal re-entrant tachycardia (AVNRT) and accessory AV-pathways and is usually performed with 4 or 5 catheters.

This study reports the short- and long-term results of an alternative simplified approach with a 2-catheter configuration for both electrophysiological study (EPS) and CA in patients with re-entrant supraventricular tachycardias.

Methods In total, 274 consecutive patients who underwent EPS with a view to curative CA for AVNRT or AVRT were enrolled. A 2-catheter configuration was routinely used. Ablation success, acute in-hospital complications, symptoms recurrence, arrhythmia recurrence were recorded.

Results 195 patients underwent ablation of AVNRT and 79 of a single AP. Immediate success after CA ablation was achieved in 99.6% of patients. Major complications occurred in 2 patients (0.73%, 2 cases of complete AV block, one of which requiring pacemaker implantation after 1 year, one during typical AVNRT ablation and one during epicardial AP-ablation).

Vascular complications occurred in 4 patients (1.4%, 3 partial femoral vein thrombosis without embolic events, one femoral arteriovenous fistula). Minimal pericardial effusion occurred in 6 patients (2.2%). All vascular complications were medically successfully treated not requiring surgery.

The mean follow-up was 86 months. Arrhythmia recurrence was observed in 5.6% of patients (2.6% with AP, 2.9% with AVNRT); a second successful catheter ablation was performed in 2.9%.

Conclusions CA with simplified approach is effective in the treatment of supraventricular tachycardia due to APs and AVNRT and is associated with a low incidence of major and minor complications and late recurrence of arrhythmias.

• Radiofrequency catheter ablation
• supraventricular tachycardia
• simplified 2-catheter approach