Key result
Post-PVI SVT induction and ablation succeeds in ~39% of patients without prolonging procedure time.
Why the study?
Patients with AF may experience other SVTs that trigger AF and cause similar symptoms, but the safety and effectivity of inducing SVT during catheter ablation for AF needed assessment.
Does inducing and ablating supraventricular tachycardias after pulmonary vein isolation in patients with paroxysmal atrial fibrillation affect procedure safety and time?
Observational (n=61)
No
Does inducing and ablating supraventricular tachycardias after pulmonary vein isolation in patients with paroxysmal atrial fibrillation affect procedure safety and time?
Absolute Event Rate: 148.96% vs 143.51%
p-value: p=0.408
Inducing and ablating supraventricular tachycardias after pulmonary vein isolation in paroxysmal AF patients is safe, occurs in 39% of cases, and does not prolong procedure or fluoroscopy time.
May support adding SVT induction to PVI without time cost; leaves open effect on recurrence in paroxysmal AF.
AIMS: Patients with atrial fibrillation (AF) may experience other supraventricular tachycardias (SVT) that can trigger AF and cause similar symptoms. The aim of this study was to assess the safety and effectivity of inducing SVT in patients undergoing catheter ablation (CA) for AF. METHODS: In 61 patients with paroxysmal AF undergoing CA between January 2022 and March 2023, an electrophysiological study was performed after pulmonary vein isolation (PVI) to induce SVT. Induced arrhythmias were mapped and ablated. All patients were followed up at 3, 6, and 12 months after the procedure; seven-day ECG Holter monitoring was carried out 6 and 12 months after the procedure. RESULTS: In 24 patients (39%) an SVT was induced during the stimulation protocol. There was no significant difference in procedure time (P=0.408) or fluoroscopy dose (P=0.458) between patients with and without inducible arrhythmia. Further, none of the echocardiographic variables such as left atrial volume index (LAVI) (P=0.936), left ventricular ejection fraction (LVEF) (P=0.586), or right atrial (RA) area (P=0.716), differed significantly in these subgroups. Age was a significant factor in patients with arrhythmia inducibility compared with those without (64.5 ± 7.6 and 58.2 ± 10.5, P=0.04). CONCLUSION: SVT inducibility after successful PVI was 39%. Ablation of nonclinical arrhythmia is safe and did not prolong the total procedure or fluoroscopy time.
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Vrtal et al. (2024) conducted an observational in Paroxysmal atrial fibrillation (n=61). Induction and ablation of supraventricular tachycardias after pulmonary vein isolation vs. Non-inducible patients was evaluated on Procedure time (minutes) (p=0.408). Induction and ablation of supraventricular tachycardias after successful pulmonary vein isolation was achieved in 39% of patients and did not significantly prolong procedure time.
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