Long-term symptom improvement and patient satisfaction following catheter ablation of supraventricular tachycardia: insights from the German ablation registry.
OBJECTIVE
To analyse outcomes of supraventricular tachycardia (SVT) ablations performed within a prospective German Ablation Quality Registry.


RESULTS
Data from 12 566 patients who underwent catheter ablation of SVT between January 2007 and January 2010 to treat atrial fibrillation (AFIB, 37.2% of procedures), atrial flutter (AFL, 29.9%), atrioventricular nodal re-entrant tachycardia (AVNRT, 23.2%), atrioventricular re-entrant tachycardia (6.3%), and focal atrial tachycardia (AT, 3.4%) were prospectively collected. Patients were followed for at least 1 year. The periprocedural success rate was 96.3%, ranging from 84.3% (focal AT) to 98.9% (AVNRT). Kaplan-Meier mortality estimate at 1 year was 1.4% overall, and as high as 2.6% in the AFL group and 2.8% in the focal AT group. Recurrence of ablated or another symptomatic SVT was observed in 3783 (32.6%) of patients, ranging from 17.2% (AVNRT) to 45.6% (AFIB). Repeat ablation was performed in 12.0% of patients. After 1 year, 74.1% of survivors perceived ablation therapy as successful, 15.7% as partly successful, and 9.6% as unsuccessful. Even in those patients with arrhythmia recurrence, 76.0% perceived ablation as successful or partly successful and 89.6% would still undergo repeat ablation in the same institution.


CONCLUSIONS
Ablation therapy for SVT is a safe procedure bringing symptomatic improvement and satisfaction to three quarters of patients after 1 year. Even in patients with arrhythmia recurrence, a high satisfaction level and adherence to the ablating institution could be documented. Strikingly high mortality and stroke rates in follow-up were observed in AFL patients, who apparently need consistent long-term anticoagulation and more medical attention.
Department of Cardiology, Angiology, and Pneumology, Second Medical Clinic, Coburg Hospital, Coburg, Germany.
Johannes
J
Brachmann
Department of Medicine-Cardiology and Intensive Care, Hospital Munich-Thalkirchen, Am Isarkanal 36, 81379 Munich, Germany.
Thorsten
T
Lewalter
Department of Cardiology, Asklepios Klinik St Georg, Hamburg, Germany.
Karl-Heinz
KH
Kuck
Department of Cardiology and Internal Medicine, Vivantes Klinikum Am Urban, Berlin, Germany.
Dietrich
D
Andresen
Department of Electrophysiology, University Heart Center Hamburg, Hamburg, Germany.
Stephan
S
Willems
Praxisklinik Herz und Gefaesse, Dresden, Germany and Institute of Medical Technology Brandenburg University of Technology Cottbus - Senftenberg, Germany.
Stefan G
SG
Spitzer
Heart Center Munich-Bogenhausen, Munich Municipal Hospital Group, Germany.
Florian
F
Straube
Herz- und Gefaessklinik, Bad Neustadt/Saale, Germany (old institution), Westpfalz-Klinikum GmbH, Kaiserslautern, Germany (new institution).
Burghard
B
Schumacher
Division of Electrophysiology, Department of Cardiology and Angiology, University of Muenster, Muenster, Germany.
Lars
L
Eckardt
Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.
Dejan
D
Danilovic
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Dierk
D
Thomas
Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.
Matthias
M
Hochadel
Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.
Jochen
J
Senges
D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000523:psychology / Q000601:surgery; D001282:Atrial Flutter / Q000401:mortality / Q000523:psychology / Q000601:surgery; D017115:Catheter Ablation / Q000401:mortality / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012008:Recurrence; D012042:Registries; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000401:mortality / Q000523:psychology / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D016896:Treatment Outcome
Atrial fibrillation; Atrial flutter ; Catheter ablation ; Complications ; Registries ; Tachycardia 