Extremely late recurrences (≥3 years) of atrioventricular nodal reentrant tachycardia: Electrophysiological characteristics of the index and repeat ablation procedures

Chye Gen Chin, Fa Po Chung, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Chin Yu Lin, Ting Yung Chang, Jennifer Jeanne B. Vicera, Chun Chao Chen, Chieh Mao Chuang, Wen Han Cheng, Shin Huei Liu, Ming Hsiung Hsieh, Shih Ann Chen

Research output: Contribution to journalArticle

Abstract

Background: Catheter ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). However, the characteristics of extremely late (>3 years) recurrences of AVNRT after a successful initial ablation are not fully elucidated. We aimed to explore the electrophysiological characteristics of extremely late recurrences of AVNRT after a successful ablation. Methods: From 1991 to 2018, 3311 patients (mean age: 48.7 ± 17.4 years; men: 1328 [40.1%]) who underwent catheter ablation for AVNRT were investigated. Baseline characteristics of the patients, recurrence status, and detailed electrophysiological parameters of the index and repeat ablation procedures were obtained for analysis. Results: After a mean follow-up period of 129.5 ± 58.0 months, 65 (2.0%) patients underwent repeat ablation for recurrences of AVNRT, of whom 17 (0.5%) presented with extremely late recurrences. The incidence of transient AV block was significantly higher in patients with extremely late recurrences (5.9%) than in those without recurrences (1.9%) but lower than that in patients with recurrences within <3 years (12.5%, P < .001). In addition, among patients with extremely late recurrences of AVNRT, the atrial–His bundle interval was significantly longer (99.1 ± 23.4 vs. 76.5 ± 13.1 ms, P < .01) and the need for intravenous isoproterenol and/or atropine for the induction of AVNRT (88.2% vs. 47.1%, P = .03) was higher in the repeat ablation procedure than in the index ablation procedure. Conclusion: Recurrences of AVNRT can occur 3 years after a successful initial ablation. The electrophysiological features of the index and repeat ablation procedures differed between patients with extremely late recurrences of AVNRT and those with recurrences within <3 years.

Original languageEnglish
Pages (from-to)70-75
Number of pages6
JournalInternational Journal of Cardiology
Volume305
DOIs
Publication statusPublished - Apr 15 2020

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Keywords

  • Atrioventricular nodal reentrant tachycardia
  • Late recurrence
  • Radiofrequency catheter ablation
  • Repeat procedure
  • Slow pathway

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chin, C. G., Chung, F. P., Lin, Y. J., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Chao, T. F., Liao, J. N., Lin, C. Y., Chang, T. Y., Vicera, J. J. B., Chen, C. C., Chuang, C. M., Cheng, W. H., Liu, S. H., Hsieh, M. H., & Chen, S. A. (2020). Extremely late recurrences (≥3 years) of atrioventricular nodal reentrant tachycardia: Electrophysiological characteristics of the index and repeat ablation procedures. International Journal of Cardiology, 305, 70-75. https://doi.org/10.1016/j.ijcard.2020.02.007