title: AV nodal reentrant tachycardia or AV reentrant tachycardia using a concealed bypass tract-related adverse events.
abstract: OBJECTIVE
  To jointly study paroxysmal supraventricular tachycardia (SVT)-related adverse events (AE) and ablation-related complications, with specific emphasis on the predictors of SVT-related AE as well as their significance by investigating their association with long-term mortality.
  
  
  METHODS
  1770 patients were included, aged 6 to 97, with either atrioventricular nodal reentrant tachycardia (AVNRT) or orthodromic atrioventricular reciprocal tachycardia (AVRT) mediated by concealed accessory pathway, consecutively referred for SVT work-up in a tertiary care center.
  
  
  RESULTS
  SVT-related AE were identified in 339 patients (19%). Major AEs were identified in 23 patients (1%; 15 cardiac arrests or ventricular arrhythmias requiring cardioversion and 8 hemodynamic collapses). Other AE were related to syncope (n=236), acute coronary syndrome (n=57) and heart failure/rhythmic cardiomyopathy (n=21). In multivariable analysis, higher age, heart disease and requirement of isoproterenol to induce SVT were independently associated with a higher risk for SVT-related AE. During follow-up (2.8±3.0years), death occurred more frequently in patients with SVT-related AE, especially in patients with major adverse events (p<0.001). In multivariable analysis, major SVT-related AE remained significantly associated with occurrence of death (HR=6.72, IC=(2.58-17.52), p<0.001) independently of age and presence of underlying heart disease. Major SVT-related AE in the whole population referred for SVT were more frequent than immediate major ablation complications in patients undergoing SVT ablation (5/1186 vs. 23/1770, p=0.02).
  
  
  CONCLUSIONS
  SVT-related AE are independent predictors of mortality and are more frequent than immediate major ablation complications in patients undergoing SVT ablation. The present findings support systematically performing SVT ablation in patients with SVT-related adverse events.
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France. Electronic address: b.brembilla-perrot@chu-nancy.fr.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Brembilla-Perrot
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Bénichou
authors.affiliation: Epidemiology, CHU de Besançon, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Brembilla
authors.affiliation: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, Institut Lorrain du cœur et des vaisseaux, CHU de Nancy, Nancy, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Bozec
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dorlet
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Sellal
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Olivier
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Manenti
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Villemin
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Beurrier
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Moulin-Zinsch
authors.affiliation: Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France.
authors.forename: Christian
authors.initials: C
authors.lastname: De Chillou
authors.affiliation: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, Institut Lorrain du cœur et des vaisseaux, CHU de Nancy, Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006323:Heart Arrest / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D013614:Tachycardia, Paroxysmal / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult
keywords: Ablation; Adverse events; Antiarrhythmic drug; Supraventricular tachycardia