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Open Access 01-12-2018 | Research

Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia

Authors: 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

Published in: European Journal of Medical Research | Issue 1/2018

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.

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Title: Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia
Authors: 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
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: European Journal of Medical Research / Issue 1/2018
Electronic ISSN: 2047-783X
DOI: https://doi.org/10.1186/s40001-018-0314-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical impact of “pure” empirical catheter ablation of slow-pathway in patients with non-ECG documented clinical on–off tachycardia

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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