title: Recurrent supraventricular tachycardias prevalence and pathophysiology after RF ablation: A 5-year registry.
abstract: BACKGROUND
  The introduction of technique of radiofrequency (RF) catheter ablation in 1990, has revolutionized management of different types of paroxysmal supraventricular tachycardia (PSVT). In spite of higher success rate, there were reported recurrences among different types of SVT. The aim of this study was to report the efficacy of RF ablation, its complications, recurrence rate and its predictors.
  
  
  METHODS
  The material of this study (our 3rd registry) included patients who underwent electrophysiological study (EPS) and radiofrequency ablation of their supraventricular tachycardia in the past 5 years, starting from January 2002 to January 2007 at The Critical Care Medicine Department, Cairo University.
  
  
  RESULTS
  Out of 400 pts studied, 381 (95%) had been subjected to radiofrequency ablation (RF) ablation while the remaining 19 pts (4.7%) refused ablation for fear of possible complications. Out of the 381 pts, 366 (96%) had their target tachycardia successfully terminated, from them 26 pts (7%) experienced recurrence after having successful RF ablation. Nine pts (34.6%) of total recurrence was reported in pts with AVNRT, 7 pts (26.9%) of total recurrence was reported in pts with AVRT utilizing septal accessory pathway (Rt AS and /or Rt PS AP), 4 pts (15.4%) was reported in pts with double AP, 2 pts (7.7%) of total recurrence was reported in pts with AFl, one pt (3.8%) of total recurrence was reported in cases of AT. Redo ablation have been carried out successfully in 25 pts (96.2%), and one pt (3.8%) refused ablation for fear of possible complications.
  
  
  CONCLUSIONS
  Although electrophysiological study and RF ablation eliminated different types of SVT. However, there may be increased incidence of recurrence among pts with AVNRT and AVRT utilizing concealed septal AP and multiple APs secondary to the complexity of AVN physiology, the critical location of septal AP, the clinical expertise, and poor electrophysiological criteria for good procedural success.
authors: Critical Care Department, Faculty of Medicine, Cairo University, Egypt.
authors: Khaled
authors: K
authors: Hussien
authors: Mohamed
authors: M
authors: Hammouda
authors: Hazem
authors: H
authors: Elakbawy
authors: Ahmed
authors: A
authors: Abdelaziz
authors: Ahmed
authors: A
authors: Abdelaal
authors: Mohamed
authors: M
authors: Shehata
authors: El Shazly
authors: el S
authors: Abdelkhalik
authors: Hassan
authors: H
authors: Nagi
authors: Sherif
authors: S
authors: Mokhtar
keywords: Radiofrequency ablation; Recurrence; Supraventricular tachycardia
references: J Cardiovasc Electrophysiol. 2003 Aug;14(8):791-9
references: 12890036
references: N Engl J Med. 1991 Jun 6;324(23):1605-11
references: 2030716
references: Pacing Clin Electrophysiol. 2005 Feb;28(2):102-10
references: 15679639
references: J Am Coll Cardiol. 2002 Feb 20;39(4):689-94
references: 11849870
references: J Cardiovasc Electrophysiol. 2005 Sep;16(9):960-6
references: 16174016
references: Heart Rhythm. 2006 Mar;3(3):253-8
references: 16500293
references: Z Kardiol. 2002 May;91(5):389-95
references: 12132285
references: Rev Med Chil. 2003 Nov;131(11):1237-42
references: 14743683
references: Pacing Clin Electrophysiol. 2000 Apr;23(4 Pt 1):477-80
references: 10793437
references: Pacing Clin Electrophysiol. 2007 Sep;30(9):1129-35
references: 17725757
references: Eur Heart J. 1994 Mar;15(3):339-44
references: 8013506
references: J Am Coll Cardiol. 2003 Oct 15;42(8):1493-531
references: 14563598
references: J Am Coll Cardiol. 1998 Mar 1;31(3):593-601
references: 9502641
references: J Cardiovasc Electrophysiol. 1998 Apr;9(4):355-65
references: 9581952
references: Circulation. 2000 Dec 19;102(25):3080-5
references: 11120698
references: Am J Cardiol. 1993 May 1;71(12):1104-5
references: 8475877
references: J Cardiovasc Electrophysiol. 2004 Jul;15(7):759-70
references: 15250858
references: J Am Coll Cardiol. 2002 Jun 5;39(11):1827-35
references: 12039499
references: Indian Pacing Electrophysiol J. 2002 Apr 01;2(2):45-9
references: 17006556
references: Eur Heart J. 2001 Jan;22(1):82-8
references: 11133213
references: J Interv Card Electrophysiol. 2006 Apr;15(3):191-6
references: 16915363
references: Pacing Clin Electrophysiol. 1997 May;20(5 Pt 1):1312-7
references: 9170132
references: J Cardiovasc Electrophysiol. 1998 Dec;9(12):1370-7
references: 9869537
references: Circulation. 1999 Dec 21-28;100(25):2507-13
references: 10604888
references: Circulation. 1999 Jan 19;99(2):262-70
references: 9892593