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A. Basics
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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35. Research Methodology
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Short-term atrial tachycardia recurrence and clinical improvement after catheter ablation: are there worst results in structural heart disease?
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Alexandra Castelo
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.4 Supraventricular Tachycardia (non-AF) - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Alexandra Castelo; Guilherme Portugal; Bárbara Teixeira; Pedro Garcia Brás; Vera Vaz Ferreira; José Viegas; Bruno Valente; Pedro Silva Cunha; Manuel Brás; Ana Delgado; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p><strong>Background</strong>: Focal atrial tachycardia (AT) is a relatively uncommon arrhythmia, often requiring treatment with radiofrequency (RF) catheter ablation. However, ablation tends to be less often considered in patients (P) with structural heart disease.</p> <p><strong>Purpose:</strong> To compare short-term recurrence rates and clinical improvement after AT ablation in P with different underlying cardiac substrates. </p> <p><strong>Methods: </strong>Retrospective analysis of consecutive P who were submitted to AT ablation between 2015 and 2020. Electroanatomical mapping was employed in all cases. RF was delivered at the site of earliest activation after validation of local electrograms until non-inducibility was obtained. During follow-up, AT recurrence was documented by 12-lead electrocardiograms (EKG) or 24h Holter monitoring.</p> <p><strong>Results:</strong> A total of 46P were included (48±23years - minimum 8 months, maximum 86 years -, female 60.9%). Idiopathic AT was observed in 47.8%, while 52.2% of the P had associated comorbidities (pulmonary disease 17.4%; previous cardiac surgery [PCS] 8.7%; congenital heart disease [CHD] 10.9%; coronary artery disease 6.5%). Palpitations were the most frequent symptom (87%), followed by dizziness or syncope (21.7%). Nearly half of the P (47.8%) had previously sought urgent medical care and 30.4% had hospital admissions due to arrhythmia. During the electrophysiologic study, a focal AT was observed in all P, and a focal RF ablation was done with success. There were no major complications related with the procedure. On the follow-up period (mean 320±92 days) after AT ablation, there was a 3-fold decrease in urgent medical care visits and in hospital admissions for arrhythmia. AT (70% sustained and 30% self-limited) was documented in 10P (21.7%, by EKG in 7P and Holter in 3P) and symptoms improved in 88.1% of the cases. There was no difference on AT recurrence according to age (p=0.658), gender (p=0.426), idiopathic AT (p=0.575), PCS (p=0.152), CHD (p=0.294), pulmonary disease (p=0.486) or coronary revascularization (p=0.615). P with a PCS or CHD tended to have less symptoms improvement after ablation (p=0.022 and p=0.058, respectively). </p> <p><strong>Conclusion:</strong> RF ablation for AT is a safe and effective treatment option, with good short-term outcomes. Success rates are high, even in P with structural heart disease, although P with CHD or PCS tend to have less symptomatic improvement.</p>
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