Key result
Tachycardia-bradycardia syndrome was associated with a higher rate of atrial tachyarrhythmia recurrence after a single ablation procedure compared to patients without the syndrome (51.0% vs. 38.5%; p=0.008).
Why the study?
Reports evaluating long-term outcomes following atrial fibrillation ablation for tachycardia-bradycardia syndrome remain limited.
Does radiofrequency catheter ablation affect atrial tachyarrhythmia recurrence and permanent pacemaker implantation avoidance in patients with tachycardia-bradycardia syndrome compared to those without?
Cohort (n=159)
Does radiofrequency catheter ablation affect atrial tachyarrhythmia recurrence and permanent pacemaker implantation avoidance in patients with tachycardia-bradycardia syndrome compared to those without?
Absolute Event Rate: 51% vs 38.5%
p-value: p=0.008
Radiofrequency catheter ablation for paroxysmal AF in patients with tachycardia-bradycardia syndrome is associated with a higher initial recurrence rate but successfully avoids permanent pacemaker implantation in 92.5% of patients.
Higher ATA recurrence after single ablation in TBS warrants closer monitoring; leaves open optimal strategies for durable pacemaker avoidance.
Background Reports of long‐term outcomes after atrial fibrillation (AF) ablation for tachycardia‐bradycardia syndrome (TBS) are limited. This study aimed to investigate the impact of radiofrequency catheter ablation (RFCA) on clinical outcomes in patients with TBS. Methods Among 1669 patients who underwent AF ablation between January 2010 and April 2020, we retrospectively enrolled 53 patients (62.3% males; age, 67.1 ± 7.0 years) who had been diagnosed with TBS before RFCA for paroxysmal AF (TBS group). After 1:2 propensity score‐matching based on age, gender, AF type, and left atrial dimension, 106 patients were assigned to the control group (non‐TBS group). The atrial tachyarrhythmia (ATA) recurrence rate and rate of avoidance of permanent pacemaker implantation (PMI) were examined. Results During a median follow‐up period of 37.7 months, the ATA recurrence rate after a single ablation procedure was significantly higher in the TBS group than in the non‐TBS group (51.0% vs. 38.5%; log‐rank p = .008); however, the ATA recurrence rate after the final ablation procedure did not significantly differ between groups. In the TBS group, the rate of PMI avoidance after AF ablation was 92.5%. A Cox‐regression multivariate analysis revealed that the presence of non‐pulmonary vein/superior vena cava premature atrial contractions (odds ratio, 3.38; 95% confidence interval, 1.49–7.66; p = .004) was an independent predictor of ATA recurrence in the TBS group. Conclusions Patients with TBS had higher ATA recurrence rates after the first ablation procedure compared to those without TBS. However, ATA recurrence after AF ablation did not necessarily result in PMI for TBS patients.
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Kataoka et al. (2022) conducted a cohort in Tachycardia-bradycardia syndrome with paroxysmal atrial fibrillation (n=159). Tachycardia-bradycardia syndrome vs. Non-tachycardia-bradycardia syndrome was evaluated on Atrial tachyarrhythmia recurrence after a single ablation procedure (p=0.008). Tachycardia-bradycardia syndrome was associated with a higher rate of atrial tachyarrhythmia recurrence after a single ablation procedure compared to patients without the syndrome (51.0% vs. 38.5%; p=0.008).
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