导管消融治疗成人先天性心脏病室上性心律失常:复发率和急性手术成功的预测因素

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Ahmed El-Medany , Nicholas Sunderland , Richard Dobson , Graham Stuart , Ashley Nisbet
{"title":"导管消融治疗成人先天性心脏病室上性心律失常:复发率和急性手术成功的预测因素","authors":"Ahmed El-Medany ,&nbsp;Nicholas Sunderland ,&nbsp;Richard Dobson ,&nbsp;Graham Stuart ,&nbsp;Ashley Nisbet","doi":"10.1016/j.ijcchd.2023.100445","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><p>To define the cohort of adult congenital heart disease (ACHD) patients undergoing catheter ablation for supraventricular arrhythmia in a large tertiary centre, characterise outcomes, and determine factors associated with arrhythmia recurrence.</p></div><div><h3>Methods</h3><p>Single centre retrospective study of all catheter ablations for atrial arrhythmias in ACHD patients between September 2014 and October 2021. Patients were identified using a field search through a centralised database. Pre-specified clinical and procedural data of interest, and time from ablation to recurrence, were determined. Cox regression analyses were used to determine potential predictors of acute procedural success and arrhythmia recurrence.</p></div><div><h3>Results</h3><p>Cardiac ablation for supraventricular arrhythmia was undertaken in 142 cases across 100 unique patients (median age 41, interquartile range 31–52), with 70 (49%) cases treated for macro-reentrant atrial tachycardia, 16 (11%) for focal atrial tachycardia, 19 (13%) for multifocal atrial tachycardia, 17 (12%) for atrial fibrillation, 7 (5%) for atrioventricular nodal reentrant tachycardia, and 8 (6%) for atrioventricular reentrant tachycardia; and 68 cases (48%) had recurrent arrhythmia with a median time to recurrence of 800 days. Multivariable analysis identified acute procedural success as an independent predictor of freedom from arrhythmia, and ablation for persistent atrial fibrillation as an independent predictor for recurrence of arrhythmia.</p></div><div><h3>Conclusion</h3><p>Catheter ablation for supraventricular arrhythmia in ACHD patients is safe and effective, with most patients achieving multiple arrhythmia-free months. Procedural success and arrhythmia mechanism are important predictors of recurrence.</p></div>","PeriodicalId":73429,"journal":{"name":"International journal of cardiology. Congenital heart disease","volume":null,"pages":null},"PeriodicalIF":0.8000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Catheter ablation for supraventricular arrhythmias in adults with congenital heart disease: Recurrence rates and predictors of acute procedural success\",\"authors\":\"Ahmed El-Medany ,&nbsp;Nicholas Sunderland ,&nbsp;Richard Dobson ,&nbsp;Graham Stuart ,&nbsp;Ashley Nisbet\",\"doi\":\"10.1016/j.ijcchd.2023.100445\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>To define the cohort of adult congenital heart disease (ACHD) patients undergoing catheter ablation for supraventricular arrhythmia in a large tertiary centre, characterise outcomes, and determine factors associated with arrhythmia recurrence.</p></div><div><h3>Methods</h3><p>Single centre retrospective study of all catheter ablations for atrial arrhythmias in ACHD patients between September 2014 and October 2021. Patients were identified using a field search through a centralised database. Pre-specified clinical and procedural data of interest, and time from ablation to recurrence, were determined. Cox regression analyses were used to determine potential predictors of acute procedural success and arrhythmia recurrence.</p></div><div><h3>Results</h3><p>Cardiac ablation for supraventricular arrhythmia was undertaken in 142 cases across 100 unique patients (median age 41, interquartile range 31–52), with 70 (49%) cases treated for macro-reentrant atrial tachycardia, 16 (11%) for focal atrial tachycardia, 19 (13%) for multifocal atrial tachycardia, 17 (12%) for atrial fibrillation, 7 (5%) for atrioventricular nodal reentrant tachycardia, and 8 (6%) for atrioventricular reentrant tachycardia; and 68 cases (48%) had recurrent arrhythmia with a median time to recurrence of 800 days. Multivariable analysis identified acute procedural success as an independent predictor of freedom from arrhythmia, and ablation for persistent atrial fibrillation as an independent predictor for recurrence of arrhythmia.</p></div><div><h3>Conclusion</h3><p>Catheter ablation for supraventricular arrhythmia in ACHD patients is safe and effective, with most patients achieving multiple arrhythmia-free months. Procedural success and arrhythmia mechanism are important predictors of recurrence.</p></div>\",\"PeriodicalId\":73429,\"journal\":{\"name\":\"International journal of cardiology. Congenital heart disease\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of cardiology. Congenital heart disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666668523000071\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology. Congenital heart disease","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666668523000071","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

目的:确定在大型三级中心接受导管消融治疗室上性心律失常的成人先天性心脏病(ACHD)患者队列,描述结果,并确定与心律失常复发相关的因素。方法对2014年9月至2021年10月期间所有房性心律失常患者导管消融的单中心回顾性研究。通过中央数据库进行现场搜索,确定患者。确定预先指定的临床和手术数据,以及从消融到复发的时间。Cox回归分析用于确定急性手术成功和心律失常复发的潜在预测因素。结果在100例特殊患者(中位年龄41岁,四分位数范围31-52岁)中,142例室上性心律失常接受了心脏消融术治疗,其中大室上性心动过速70例(49%),局灶性心动过速16例(11%),多灶性心动过速19例(13%),房颤17例(12%),房室结型心动过速7例(5%),房室重入性心动过速8例(6%);68例(48%)心律失常复发,平均复发时间为800天。多变量分析发现,急性手术成功是心律失常解除的独立预测因素,持续性房颤消融是心律失常复发的独立预测因素。结论导管消融治疗室上性心律失常是安全有效的,大多数患者可达到多个月无心律失常。手术成功和心律失常机制是预测复发的重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Catheter ablation for supraventricular arrhythmias in adults with congenital heart disease: Recurrence rates and predictors of acute procedural success

Aims

To define the cohort of adult congenital heart disease (ACHD) patients undergoing catheter ablation for supraventricular arrhythmia in a large tertiary centre, characterise outcomes, and determine factors associated with arrhythmia recurrence.

Methods

Single centre retrospective study of all catheter ablations for atrial arrhythmias in ACHD patients between September 2014 and October 2021. Patients were identified using a field search through a centralised database. Pre-specified clinical and procedural data of interest, and time from ablation to recurrence, were determined. Cox regression analyses were used to determine potential predictors of acute procedural success and arrhythmia recurrence.

Results

Cardiac ablation for supraventricular arrhythmia was undertaken in 142 cases across 100 unique patients (median age 41, interquartile range 31–52), with 70 (49%) cases treated for macro-reentrant atrial tachycardia, 16 (11%) for focal atrial tachycardia, 19 (13%) for multifocal atrial tachycardia, 17 (12%) for atrial fibrillation, 7 (5%) for atrioventricular nodal reentrant tachycardia, and 8 (6%) for atrioventricular reentrant tachycardia; and 68 cases (48%) had recurrent arrhythmia with a median time to recurrence of 800 days. Multivariable analysis identified acute procedural success as an independent predictor of freedom from arrhythmia, and ablation for persistent atrial fibrillation as an independent predictor for recurrence of arrhythmia.

Conclusion

Catheter ablation for supraventricular arrhythmia in ACHD patients is safe and effective, with most patients achieving multiple arrhythmia-free months. Procedural success and arrhythmia mechanism are important predictors of recurrence.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
International journal of cardiology. Congenital heart disease
International journal of cardiology. Congenital heart disease Cardiology and Cardiovascular Medicine
自引率
0.00%
发文量
0
审稿时长
83 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信