What question did this study set out to answer?

To evaluate the incidence, causes, and clinical predictors of in-hospital mortality following direct current catheter ablation of the atrioventricular junction for refractory supraventricular tachycardias.

November 1, 1991Circulation

Predictors of in-hospital mortality after DC catheter ablation of atrioventricular junction. Results of a prospective, international, multicenter study.

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Why the study?

What are the predictors of in-hospital mortality after DC catheter ablation of the atrioventricular junction in patients with uncontrollable supraventricular tachycardias?

Key Points

To evaluate the incidence, causes, and clinical predictors of in-hospital mortality following direct current catheter ablation of the atrioventricular junction for refractory supraventricular tachycardias.
Prospective, international multicenter registry evaluating 136 patients undergoing direct current catheter ablation to induce complete atrioventricular block between August 1987 and March 1990.
Assessed in-hospital mortality, procedural success rates, and comparative baseline clinical and electrophysiological characteristics between survivors and non-survivors.
In-hospital mortality occurred in 8 patients, with 7 deaths (5.1%) directly or indirectly related to ablation, predominantly caused by ventricular fibrillation (n=5).
Patients who died had significantly higher rates of congestive heart failure (88% vs 22%, p<0.001), cardiomyopathy (50% vs 16%, p<0.05), and prior aborted sudden death (38% vs 2%, p<0.05).
Mortality was associated with lower baseline ejection fraction (27% vs 52%, p<0.001), lower systolic blood pressure (106 vs 138 mm Hg, p<0.001), and prolonged baseline and postablation corrected QT intervals (p<0.01).

Structured PICO

What are the predictors of in-hospital mortality after DC catheter ablation of the atrioventricular junction in patients with uncontrollable supraventricular tachycardias?

Population

136 patients with uncontrollable supraventricular tachycardias undergoing attempted production of third-degree atrioventricular block

Intervention

DC catheter ablation of the atrioventricular junction

Outcome

In-hospital mortalityhard clinical

DC catheter ablation of the AV junction carries a significant risk of death (5.1%), particularly from lethal arrhythmias in patients with severe left ventricular dysfunction.

Discussion

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Implication

High in-hospital mortality after DC AV junction ablation in severe LV dysfunction warrants caution; leaves open optimal patient selection criteria.

Cite This Study

EVANS et al. (1991) studied this question.

synapsesocial.com/papers/6a10d0168102eb4b66ee75d0 https://doi.org/10.1161/01.cir.84.5.1924

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Implication

High in-hospital mortality after DC AV junction ablation in severe LV dysfunction warrants caution; leaves open optimal patient selection criteria.

Predictors of in-hospital mortality after DC catheter ablation of atrioventricular junction. Results of a prospective, international, multicenter study.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Predictors of in-hospital mortality after DC catheter ablation of atrioventricular junction. Results of a prospective, international, multicenter study.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider