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Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia

Background: The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP). Methods: A retrospective single-center review of patients who underwent...

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Autores principales: Telishevska, Marta, Lengauer, Sarah, Reents, Tilko, Kantenwein, Verena, Popa, Miruna, Bahlke, Fabian, Englert, Florian, Erhard, Nico, Deisenhofer, Isabel, Hessling, Gabriele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607303/
https://www.ncbi.nlm.nih.gov/pubmed/37892670
http://dx.doi.org/10.3390/jcm12206532
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author Telishevska, Marta
Lengauer, Sarah
Reents, Tilko
Kantenwein, Verena
Popa, Miruna
Bahlke, Fabian
Englert, Florian
Erhard, Nico
Deisenhofer, Isabel
Hessling, Gabriele
author_facet Telishevska, Marta
Lengauer, Sarah
Reents, Tilko
Kantenwein, Verena
Popa, Miruna
Bahlke, Fabian
Englert, Florian
Erhard, Nico
Deisenhofer, Isabel
Hessling, Gabriele
author_sort Telishevska, Marta
collection PubMed
description Background: The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP). Methods: A retrospective single-center review of patients who underwent ESP ablation between December 2014 and September 2022 was performed. Follow-up included telephone communication, letter questionnaire and outpatient presentation. Recurrence was based on typical symptoms. Results: 115 patients aged 6–81 years (median age 36.3 years, 59.1% female; 26 pts < 18 years) were included. A typical history was present in all patients (100%), an ECG documentation of narrow complex tachycardia in 97 patients (84%). Patients were divided into three groups: Group 1 without DAVNP (n = 23), Group 2 with AH jump (n = 30) and Group 3 with AH jump and at least one AV nodal echo beat (n = 62). No permanent AV block was observed. During a median follow-up of 23.6 ± 22.7 months, symptom recurrence occurred in 7/115 patients (6.1%) with no significant difference between the groups (p = 0.73, log-rank test). Symptom recurrence occurred significantly more often in patients without (5/18 patients; 27%) as compared to patients with ECG documentation (2/97 patients; 2.1%; p = 0.025). No correlation between age and success rate was found (p > 0.1). Conclusions: ESP ablation is effective and safe in patients with non-inducible AVNRT. Overall, recurrence of symptoms during long-term follow-up is low, even if no DAVNP is present. Tachycardia documentation before the EP study leads to a significantly lower recurrence rate following ESP ablation.
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spelling pubmed-106073032023-10-28 Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia Telishevska, Marta Lengauer, Sarah Reents, Tilko Kantenwein, Verena Popa, Miruna Bahlke, Fabian Englert, Florian Erhard, Nico Deisenhofer, Isabel Hessling, Gabriele J Clin Med Article Background: The aim of this study was to assess long-term efficacy and safety of empirical slow pathway (ESP) ablation in pediatric and adult patients with a special interest in patients without dual AV nodal physiology (DAVNP). Methods: A retrospective single-center review of patients who underwent ESP ablation between December 2014 and September 2022 was performed. Follow-up included telephone communication, letter questionnaire and outpatient presentation. Recurrence was based on typical symptoms. Results: 115 patients aged 6–81 years (median age 36.3 years, 59.1% female; 26 pts < 18 years) were included. A typical history was present in all patients (100%), an ECG documentation of narrow complex tachycardia in 97 patients (84%). Patients were divided into three groups: Group 1 without DAVNP (n = 23), Group 2 with AH jump (n = 30) and Group 3 with AH jump and at least one AV nodal echo beat (n = 62). No permanent AV block was observed. During a median follow-up of 23.6 ± 22.7 months, symptom recurrence occurred in 7/115 patients (6.1%) with no significant difference between the groups (p = 0.73, log-rank test). Symptom recurrence occurred significantly more often in patients without (5/18 patients; 27%) as compared to patients with ECG documentation (2/97 patients; 2.1%; p = 0.025). No correlation between age and success rate was found (p > 0.1). Conclusions: ESP ablation is effective and safe in patients with non-inducible AVNRT. Overall, recurrence of symptoms during long-term follow-up is low, even if no DAVNP is present. Tachycardia documentation before the EP study leads to a significantly lower recurrence rate following ESP ablation. MDPI 2023-10-15 /pmc/articles/PMC10607303/ /pubmed/37892670 http://dx.doi.org/10.3390/jcm12206532 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Telishevska, Marta
Lengauer, Sarah
Reents, Tilko
Kantenwein, Verena
Popa, Miruna
Bahlke, Fabian
Englert, Florian
Erhard, Nico
Deisenhofer, Isabel
Hessling, Gabriele
Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title_full Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title_fullStr Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title_full_unstemmed Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title_short Long-Term Follow-Up of Empirical Slow Pathway Ablation in Pediatric and Adult Patients with Suspected AV Nodal Reentrant Tachycardia
title_sort long-term follow-up of empirical slow pathway ablation in pediatric and adult patients with suspected av nodal reentrant tachycardia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607303/
https://www.ncbi.nlm.nih.gov/pubmed/37892670
http://dx.doi.org/10.3390/jcm12206532
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