title: Usefulness of radiofrequency ablation of supraventricular tachycardia to decrease inappropriate shocks from implantable cardioverter-defibrillators.
abstract: Inappropriate implantable cardioverter-defibrillator (ICD) therapies can lead to significant adverse events and increased mortality. These therapies are often the result of supraventricular tachycardias (SVTs). The objective of this study was to evaluate the incidence of SVT leading to inappropriate shocks in a large cohort of patients with ICDs and assess the efficacy of radiofrequency ablation (RFA) in decreasing these therapies. Patients with ICDs and recurrent SVTs were identified. A cohort of patients with ICD therapies subsequently underwent electrophysiologic study and RFA. Eighty-four patients (13%) were found to have SVT leading to 122 inappropriate ICD shocks and 130 episodes of antitachycardia pacing therapies. Median time to SVT onset after ICD implantation was 269 days. Electrophysiologic studies were performed in 30 patients. Successful RFA was performed for atrial tachycardia, atrial flutter, or atrioventricular nodal reentrant tachycardia in 22 patients. Ninety-five percent of patients who underwent successful SVT ablation had no further inappropriate ICD therapies compared to 63% of patients in whom ablation was not performed during a mean follow-up of 20.7 ± 11.9 months. In conclusion, SVT is responsible for a significant number of inappropriate ICD therapies. RFA is an effective strategy to substantially decrease subsequent inappropriate ICD therapies.
authors: Section of Electrophysiology, Heart and Vascular Institute, Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA. mainigis@einstein.edu
authors: Sumeet K
authors: SK
authors: Mainigi
authors: Khalid
authors: K
authors: Almuti
authors: Vincent M
authors: VM
authors: Figueredo
authors: Nils A
authors: NA
authors: Guttenplan
authors: Asma
authors: A
authors: Aouthmany
authors: Jessica
authors: J
authors: Smukler
authors: Bernadette
authors: B
authors: Sheeron
authors: Bryan
authors: B
authors: Meldrum
authors: Agustina D
authors: AD
authors: Saenz
authors: Gia
authors: G
authors: Tran
authors: Allan M
authors: AM
authors: Greenspan
mesh_terms: D001145:Arrhythmias, Cardiac / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D011475:Prosthesis Failure; D015996:Survival Rate / Q000639:trends; D013617:Tachycardia, Supraventricular / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*