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Recurrences of symptoms after AV node re-entrant tachycardia ablation: A clinical arrhythmia risk score to assess putative underlying cause

Abstract : PURPOSE OF THE RESEARCH: To identify clinical factors associated with the probability for each arrhythmic mechanism causing recurring symptoms after atrioventricular nodal re-entrant tachycardia (AVNRT) ablation. Slow pathway radiofrequency ablation is used to treat AVNRT. After ablation, recurrence of symptoms due to AVNRT or other arrhythmias can occur. RESULTS: We studied 835 patients successfully treated with AVNRT ablation. Variables associated with each specific arrhythmia underlying symptom recurrence were studied by logistic regression. During a mean follow-up of 2.2 ± 2 years, 136 (16%) patients had a recurrence of symptoms. Following invasive and non-invasive studies, symptoms were mostly attributed to sinus tachycardia, recurrence of AVNRT and atrial arrhythmias (respectively 4.7%, 5.2% and 6.1%). Older age and history of atrial fibrillation were associated with a markedly increased risk of symptom recurrence due to atrial arrhythmias (OR=15.58, 7.09-35.22, p<0.001) whereas younger age was associated with a higher risk of sinus tachycardia. A simple 3-item clinical score based on age categories and atrial fibrillation history efficiently predicted atrial arrhythmia (C-Index=0.82, 0.75-0.89) and sinus tachycardia (C-Index=0.83, 0.75-0.90). 8.3% of patients with scores=0 had atrial arrhythmias whereas 100% of patients with scores ≥4 had atrial arrhythmias. CONCLUSIONS: While recurrence of symptoms after successful AVNRT ablation is relatively frequent (16%), true AVNRT recurrence accounts for only 1/3 of these recurrences. A simple clinical score based on age and history of atrial fibrillation enables efficient risk stratification for symptom recurrence attributable to atrial arrhythmias and inappropriate sinus tachycardia.
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https://hal.univ-lorraine.fr/hal-01730995
Contributor : Iadi Ul <>
Submitted on : Tuesday, March 13, 2018 - 5:11:10 PM
Last modification on : Thursday, January 7, 2021 - 4:00:03 PM

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Béatrice Brembilla-Perrot, Jean-Marc Sellal, Arnaud Olivier, Vladimir Manenti, Daniel Beurrier, et al.. Recurrences of symptoms after AV node re-entrant tachycardia ablation: A clinical arrhythmia risk score to assess putative underlying cause. International Journal of Cardiology, Elsevier, 2015, 179, pp.292 - 296. ⟨10.1016/j.ijcard.2014.11.071⟩. ⟨hal-01730995⟩

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