Key result
Sinus node sparing hybrid ablation for IST or POTS yields ~85% long-term freedom from redo procedures.
Why the study?
Long-term rates of redo procedures, procedural strategy, outcomes, and safety after novel sinus node sparing hybrid ablation for symptomatic drug-resistant IST/POTS had not been evaluated.
What is the long-term rate of redo procedures after sinus node sparing hybrid ablation in patients with drug-resistant IST/POTS?
Cohort (n=220)
No
What is the long-term rate of redo procedures after sinus node sparing hybrid ablation in patients with drug-resistant IST/POTS?
Sinus node sparing hybrid ablation for drug-resistant IST/POTS demonstrates an 84.6% long-term freedom from redo procedures with a 9.5% rate of pacemaker implantation.
AIMS: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures. METHODS AND RESULTS: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure. CONCLUSION: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.
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Asmundis et al. (2023) conducted a cohort in Inappropriate sinus tachycardia (IST) or postural orthostatic tachycardia syndrome (POTS) (n=220). Sinus node sparing hybrid ablation was evaluated on Redo procedure. Sinus node sparing hybrid ablation for IST or POTS demonstrated an 84.6% long-term freedom from redo procedures and a 9.5% pacemaker implantation rate over 73.3 months.
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