Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome
Abstract 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 patien...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12738 |
| _version_ | 1818507558636224512 |
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| author | Shohei Kataoka Koichiro Ejima Kyoichiro Yazaki Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara |
| author_facet | Shohei Kataoka Koichiro Ejima Kyoichiro Yazaki Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara |
| author_sort | Shohei Kataoka |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-10T22:20:04Z |
| format | Article |
| id | doaj.art-1cbe51beed3743c28774cab5cd2ef430 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-10T22:20:04Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-1cbe51beed3743c28774cab5cd2ef4302022-12-22T01:31:21ZengWileyJournal of Arrhythmia1880-42761883-21482022-08-0138459860710.1002/joa3.12738Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndromeShohei Kataoka0Koichiro Ejima1Kyoichiro Yazaki2Miwa Kanai3Daigo Yagishita4Morio Shoda5Nobuhisa Hagiwara6Department of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanDepartment of Cardiology Tokyo Women's Medical University Shinjuku‐ku JapanAbstract 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.https://doi.org/10.1002/joa3.12738atrial fibrillationpermanent pacemaker implantationpulmonary vein isolationtachycardia‐bradycardia syndrome |
| spellingShingle | Shohei Kataoka Koichiro Ejima Kyoichiro Yazaki Miwa Kanai Daigo Yagishita Morio Shoda Nobuhisa Hagiwara Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome Journal of Arrhythmia atrial fibrillation permanent pacemaker implantation pulmonary vein isolation tachycardia‐bradycardia syndrome |
| title | Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome |
| title_full | Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome |
| title_fullStr | Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome |
| title_full_unstemmed | Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome |
| title_short | Impact of atrial fibrillation ablation on long‐term outcomes in patients with tachycardia‐bradycardia syndrome |
| title_sort | impact of atrial fibrillation ablation on long term outcomes in patients with tachycardia bradycardia syndrome |
| topic | atrial fibrillation permanent pacemaker implantation pulmonary vein isolation tachycardia‐bradycardia syndrome |
| url | https://doi.org/10.1002/joa3.12738 |
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