Key result
Ablation time <60 seconds (OR 5.487; 95% CI 1.411-21.340; p=0.014) and junctional rhythm during ablation were independent risk factors for recurrence of para-hisian accessory pathways.
Why the study?
Ablation of para-hisian accessory pathways remains challenging due to anatomic characteristics, and few studies have investigated the causes of recurrence after radiofrequency ablation.
What are the risk factors for recurrence after successful radiofrequency ablation of para-hisian accessory pathways?
Cohort (n=113)
No
What are the risk factors for recurrence after successful radiofrequency ablation of para-hisian accessory pathways?
Odds Ratio: 5.487 (95% CI 1.411–21.34)
p-value: p=0.014
Junctional rhythm during ablation and ablation time under 60 seconds are independent risk factors for long-term recurrence of para-hisian accessory pathways.
May warrant prolonged ablation to curb recurrence in para-Hisian pathways; hypothesis-generating for technique optimization in prospective studies.
Funding Acknowledgements Type of funding sources: None. Background Ablation of para-hisian accessory pathways (APs) remains challenging due to anatomic characteristics and few studies have focused on the causes for recurrence of radiofrequency ablation of para-hisian APs. Objective This retrospective single center study was aimed to explore the risk factors for recurrence of para-hisian APs. Methods 113 patients who had a para-hisian AP with an acute success were enrolled in the study. In the 11-year follow-up, 15 cases had a recurrent para-hisian AP. Therefore 98 patients were classified into success group while 15 patients were classified into recurrence group. Demographic and ablation characteristics were analyzed. Results Gender difference was similar in two groups. The median age was 36.2 years old and was younger in recurrence group. Maximum ablation power was significantly higher in success group (29 ± 7.5 vs 22.9 ± 7.8, p < 0.01). Ablation time of final target sites was found to be markedly higher in success group (123.4 ± 53.1 vs 86.7 ± 58.3, p < 0.05). Ablation time less than 60 seconds was detected in 12 (12.2%) cases in success group and 7 (46.7%) cases in recurrence group (p < 0.01). Occurrence of junctional rhythm was significantly higher in recurrence group (25.5% vs 53.3%, p < 0.05). No severe conduction block, no pacemaker implantation and no stroke were reported. Junctional rhythm during ablation (OR = 3.833, 95%CI 1.083-13.572, p = 0.037) and ablation time <60s (OR = 5.487, 95%CI 1.411-21.340, p = 0.014) were independent risk factors for the recurrence of para-hisian AP. Conclusions Considering the long-term safety of ablation of para-hisian AP, proper extension of ablation time and increase of ablation power could be applied during operation.
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Xu et al. (2021) conducted a cohort in Para-hisian accessory pathways (n=113). Ablation time <60 seconds vs. Ablation time ≥60 seconds was evaluated on Recurrence of para-hisian accessory pathway (OR 5.487, 95% CI 1.411-21.340, p=0.014). Ablation time <60 seconds (OR 5.487; 95% CI 1.411-21.340; p=0.014) and junctional rhythm during ablation were independent risk factors for recurrence of para-hisian accessory pathways.
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