Long-term outcomes after catheter-ablation of atrioventricular nodal reentrant tachycardia: A ten-year follow-up

Aleksandar Kocijančić; Dragan  Simić; Nebojša  Mujović; Tatjana  Potpara; Vladan  Kovačević; Milan  Marinković; Jelena  Marić-Kocijančić; Dušica  Kocijančić Belović

doi:10.2298/VSP180314092K

Aleksandar Kocijančić Clinical Center of Serbia, Clinic for Cardiology
Dragan Simić Clinical Center of Serbia, Clinic for Cardiology, University of Belgrade, Faculty of Medicine
Nebojša Mujović Clinical Center of Serbia, Clinic for Cardiology; University of Belgrade, Faculty of Medicine,
Tatjana Potpara Clinical Center of Serbia, Clinic for Cardiology; University of Belgrade, Faculty of Medicine,
Vladan Kovačević Clinical Center of Serbia, Clinic for Cardiology
Milan Marinković Clinical Center of Serbia, Clinic for Cardiology
Jelena Marić-Kocijančić Military Medical Academy, Clinic of Cardiology
Dušica Kocijančić Belović Clinical Center of Serbia, Clinic for Gynaecology and Obstetrics

DOI: https://doi.org/10.2298/VSP180314092K

Keywords: tachycardia, atrioventricular nodal reentry;, catheter ablation;, arrhythmias, cardiac;, treatment outcome

Abstract

Background/Aim. Atrioventricular nodal (AV) reentry tachycardia (AVNRT) is the most common form of supraventricular tachycardia. Treatment of choice is a catheter-ablation of the slow pathway of the AV node. The aim of the study was to present the outcomes of this procedure after ten years of follow-up. Methods. The catheter-ablation procedure was performed in 92 patients (30 men and 62 women, mean age 52.0 ± 13.3 years, range 19 to 76 years) with confirmed AVNRT during the electrophysiological examination, from 2007 to 2009. Out of these, 64 patients were followed-up for ten years by inviting them to clinical examinations regularly. The occurrence of AV block, arrhythmia and the use of antyarrhythmic drugs were the main outcomes of the ten-year follow-up. Multivariate logistic regression was applied to identify significant predictors of arrhythmia after a follow-up period. Results. The primary success of intervention was achieved in 91 (98.9%) patients. Third-degree AV block was registered in 1 (1.1%) patient after the intervention, which required the implantation of a pacemaker. After ten years of follow-up, AVNRT relapses were not registered. A total of 7 out of 64 (10.9%) patients died during the follow-up period, mostly due to non-cardiac causes. After ten years of follow-up, first-degree AV block was registered in six (10.5%) patients, whereas other arrhythmias were observed in 17 (29.8%) patients such as atrial fibrillation or flutter, atrial premature beats and sinus tachycardia. The number of antiarrhythmic drugs were reduced from 2.1 ± 1.2 at baseline to 0.5 ± 0.6 during follow-up, mostly beta-blockers, propafenone and amiodarone, and 33 (57.9%) patients were no longer using anti-arrhythmic therapy. Logistic regression identified participant’s age above 55 years at baseline and re-intervention performed after the initial catheter-ablation as significant predictors of arrhythmia after a 10-year follow-up, independent from gender and arterial hypertension at baseline. Conclusion. The catheter-ablation of AVNRT represents a successful and safe procedure, from the perspective of ten-year follow-up.

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