Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia
Abstract Background Catheter ablation of slow-pathway (CaSP) has been reported to be effective in patients with dual atrioventricular nodal conduction properties (dcp-AVN) and clinical ECG documentation but without the induction of tachycardia during electrophysiological studies (EPS). However, it i...
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doaj-8821910455054fbfb45b82fa2aa055872020-11-25T00:47:43ZengBMCEuropean Journal of Medical Research2047-783X2018-03-012311710.1186/s40001-018-0314-0Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardiaShqipe Gerguri0Nikesh Jathanna1Tina Lin2Patrick Müller3Lukas Clasen4Jan Schmidt5Muhammed Kurt6Dong-In Shin7Christian Blockhaus8Malte Kelm9Alexander Fürnkranz10Hisaki Makimoto11Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfHeart Care VictoriaDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfDivision of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University DuesseldorfAbstract Background Catheter ablation of slow-pathway (CaSP) has been reported to be effective in patients with dual atrioventricular nodal conduction properties (dcp-AVN) and clinical ECG documentation but without the induction of tachycardia during electrophysiological studies (EPS). However, it is unknown whether CaSP is beneficial in the absence of pre-procedural ECG documentation and without the induction of tachycardia during EPS. The aim of this study was to evaluate long-term results after a “pure” empirical CaSP (peCaSP). Methods 334 consecutive patients who underwent CaSP (91 male, 47.5 ± 17.6 years) were included in this study. Sixty-three patients (19%) who had no pre-procedural ECG documentation, and demonstrated dcp-AVN with a maximum of one echo-beat were assigned to the peCaSP group. The remaining 271 patients (81%) were assigned to the standard CaSP group (stCaSP). Clinical outcomes of the two groups were compared, based on ECG documented recurrence or absence of tachycardia and patients’ recorded symptoms. Results CaSP was performed in all patients without any major complications including atrioventricular block. During follow-up (909 ± 435 days), 258 patients (77%) reported complete cessation of clinical symptoms. There was no statistically significant difference in the incidence of AVNRT recurrence between the peCaSP and stCaSP groups (1/63 [1.6%] vs 3/271 [1.1%], P = 0.75). Complete cessation of clinical symptoms was noted significantly less frequently in patients after peCaSP (39/63 [62%] vs 219/271 [81%], P = 0.0013). The incidence of non-AVNRT atrial tachyarrhythmias (AT) was significantly higher in patients after peCaSP (5/63 [7.9%] vs 1/271 [0.4%], P = 0.0011). Conclusion A higher incidence of other AT and subjective symptom persistence are demonstrated after peCaSP, while peCaSP improves clinical symptoms in 60% of patients with non-documented on–off tachycardia.http://link.springer.com/article/10.1186/s40001-018-0314-0AVNRTSupraventricular tachycardiaSlow-pathway ablationEmpiric ablationECG documentation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shqipe Gerguri Nikesh Jathanna Tina Lin Patrick Müller Lukas Clasen Jan Schmidt Muhammed Kurt Dong-In Shin Christian Blockhaus Malte Kelm Alexander Fürnkranz Hisaki Makimoto |
spellingShingle |
Shqipe Gerguri Nikesh Jathanna Tina Lin Patrick Müller Lukas Clasen Jan Schmidt Muhammed Kurt Dong-In Shin Christian Blockhaus Malte Kelm Alexander Fürnkranz Hisaki Makimoto Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia European Journal of Medical Research AVNRT Supraventricular tachycardia Slow-pathway ablation Empiric ablation ECG documentation |
author_facet |
Shqipe Gerguri Nikesh Jathanna Tina Lin Patrick Müller Lukas Clasen Jan Schmidt Muhammed Kurt Dong-In Shin Christian Blockhaus Malte Kelm Alexander Fürnkranz Hisaki Makimoto |
author_sort |
Shqipe Gerguri |
title |
Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia |
title_short |
Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia |
title_full |
Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia |
title_fullStr |
Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia |
title_full_unstemmed |
Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia |
title_sort |
clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ecg documented clinical on–off tachycardia |
publisher |
BMC |
series |
European Journal of Medical Research |
issn |
2047-783X |
publishDate |
2018-03-01 |
description |
Abstract Background Catheter ablation of slow-pathway (CaSP) has been reported to be effective in patients with dual atrioventricular nodal conduction properties (dcp-AVN) and clinical ECG documentation but without the induction of tachycardia during electrophysiological studies (EPS). However, it is unknown whether CaSP is beneficial in the absence of pre-procedural ECG documentation and without the induction of tachycardia during EPS. The aim of this study was to evaluate long-term results after a “pure” empirical CaSP (peCaSP). Methods 334 consecutive patients who underwent CaSP (91 male, 47.5 ± 17.6 years) were included in this study. Sixty-three patients (19%) who had no pre-procedural ECG documentation, and demonstrated dcp-AVN with a maximum of one echo-beat were assigned to the peCaSP group. The remaining 271 patients (81%) were assigned to the standard CaSP group (stCaSP). Clinical outcomes of the two groups were compared, based on ECG documented recurrence or absence of tachycardia and patients’ recorded symptoms. Results CaSP was performed in all patients without any major complications including atrioventricular block. During follow-up (909 ± 435 days), 258 patients (77%) reported complete cessation of clinical symptoms. There was no statistically significant difference in the incidence of AVNRT recurrence between the peCaSP and stCaSP groups (1/63 [1.6%] vs 3/271 [1.1%], P = 0.75). Complete cessation of clinical symptoms was noted significantly less frequently in patients after peCaSP (39/63 [62%] vs 219/271 [81%], P = 0.0013). The incidence of non-AVNRT atrial tachyarrhythmias (AT) was significantly higher in patients after peCaSP (5/63 [7.9%] vs 1/271 [0.4%], P = 0.0011). Conclusion A higher incidence of other AT and subjective symptom persistence are demonstrated after peCaSP, while peCaSP improves clinical symptoms in 60% of patients with non-documented on–off tachycardia. |
topic |
AVNRT Supraventricular tachycardia Slow-pathway ablation Empiric ablation ECG documentation |
url |
http://link.springer.com/article/10.1186/s40001-018-0314-0 |
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