Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | DOI: 10.5507/bp.2024.037

Induction of supraventricular tachycardias in patients undergoing pulmonary vein isolation for paroxysmal atrial fibrillation is safe and reasonable

Jiri Vrtal1, Jiri Plasek1, 2, David Sipula1, Jan Vaclavik1, 2, Jozef Dodulik1, Tomas Skala3, Vlastimil Cernicek4
1 Department of Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
2 Research Center for Internal and Cardiovascular Diseases Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
3 Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
4 Bata Regional Hospital, Zlin, Czech Republic

Aims: Patients with atrial fibrillation (AF) may experience other supraventricular tachycardias (SVT) that can trigger AF and cause similar symptoms. The aim of this study was to assess the safety and effectivity of inducing SVT in patients undergoing catheter ablation (CA) for AF.

Methods: In 61 patients with paroxysmal AF undergoing CA between January 2022 and March 2023, an electrophysiological study was performed after pulmonary vein isolation (PVI) to induce SVT. Induced arrhythmias were mapped and ablated. All patients were followed up at 3, 6, and 12 months after the procedure; seven-day ECG Holter monitoring was carried out 6 and 12 months after the procedure.

Results: In 24 patients (39%) an SVT was induced during the stimulation protocol. There was no significant difference in procedure time (P=0.408) or fluoroscopy dose (P=0.458) between patients with and without inducible arrhythmia. Further, none of the echocardiographic variables such as left atrial volume index (LAVI) (P=0.936), left ventricular ejection fraction (LVEF) (P=0.586), or right atrial (RA) area (P=0.716), differed significantly in these subgroups. Age was a significant factor in patients with arrhythmia inducibility compared with those without (64.5 ± 7.6 and 58.2 ± 10.5, P=0.04).

Conclusion: SVT inducibility after successful PVI was 39%. Ablation of nonclinical arrhythmia is safe and did not prolong the total procedure or fluoroscopy time.

Keywords: atrial fibrillation, supraventricular tachycardias, inducibility, ablation

Received: August 10, 2024; Revised: October 21, 2024; Accepted: November 5, 2024; Prepublished online: November 12, 2024 

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    References

    1. Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S. Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol 2014;6:213-20. Go to original source... Go to PubMed...
    2. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339(10):659-66. Go to original source... Go to PubMed...
    3. Marrouche NF, Brachmann J, Andresen D, Siebels J, Boersma L, Jordaens L et al. Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 2018;378(5):417-27. Go to original source... Go to PubMed...
    4. Hussain S, Sohrabi C, Providencia R, Ahsan S, Papageorgiou N. Catheter Ablation for the Management of Atrial Fibrillation: An Update of the Literature. Life (Basel) 2023;13(8):1784. Go to original source... Go to PubMed...
    5. Brugada J, Mont L, Matas M, Navarro-López F. Atrial fibrillation induced by atrioventricular nodal reentrant tachycardia. Am J Cardiol 1997;79(5):681-2. Go to original source... Go to PubMed...
    6. Pastor A, Núñez A, Montero M, Carbonell R, García-Cosío F. Taquicardia reentrante intranodal como inductora de fibrilación auricular [Atrioventricular nodal reentrant tachycardia as a trigger for atrial fibrillation]. Rev Esp Cardiol 2000;53(4):590-3. Go to original source... Go to PubMed...
    7. Wathen M, Natale A, Wolfe K, Yee R, Klein G. Initiation of atrial fibrillation in the Wolff-Parkinson-White syndrome: the importance of the accessory pathway. Am Heart J 1993;125(3):753-9. Go to original source... Go to PubMed...
    8. Calkins H, Kumar VK, Francis J. Radiofrequency catheter ablation of supraventricular tachycardia. Indian Pacing Electrophysiol J 2002;2(2):45-9.
    9. Palamá Z, Robles AG, Paoletti M, Nesti M, De Ruvo E, Scará A. Long-Term Follow-Up In Paroxysmal Atrial Fibrillation Patients With Documented Isolated Trigger. Front Cardiovasc Med 2023;10:1115328. Go to original source... Go to PubMed...
    10. Katritsis DG, Giazitzoglou E, Wood MA, Shepard RK, Parvez B, Ellenbogen KA. Inducible supraventricular tachycardias in patients referred for catheter ablation of atrial fibrillation. Europace 2007;9(9):785-9. Go to original source... Go to PubMed...
    11. Sciarra L, Rebecchi M, De Ruvo E, De Luca L, Zuccaro LM, Fagagnini A, Corò L, Allocca G, Lioy E, Delise P, Calò L. How many atrial fibrillation ablation candidates have an underlying supraventricular tachycardia previously unknown? Efficacy of isolated triggering arrhythmia ablation. Europace 2010;12(12):1707-12. Go to original source... Go to PubMed...
    12. Scharf C, Veerareddy S, Ozaydin M, Chugh A, Hall B, Cheung P, Good E, Pelosi F Jr, Morady F, Oral H. Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation. J Am Coll Cardiol 2004;43(11):2057-62. Go to original source... Go to PubMed...
    13. Waldo AL. Inter-relationships between atrial flutter and atrial fibrillation. Pacing Clin Electrophysiol 2003;26(7 Pt 2):1583-96. Go to original source... Go to PubMed...
    14. Jang JK, Park JS, Kim YH, Choi JI, Lim HE, Pak HN, Kim YH. Coexisting sustained tachyarrthymia in patients with atrial fibrillation undergoing catheter ablation. Korean Circ J 2010;40(5):235-8. Go to original source... Go to PubMed...
    15. Gupta A, Perera T, Ganesan A, Sullivan T, Lau DH, Roberts-Thomson KC, Brooks AG, Sanders P. Complications of catheter ablation of atrial fibrillation: a systematic review. Circ Arrhythm Electrophysiol 2013;6(6):1082-8. Go to original source... Go to PubMed...
    16. Baman TS, Jongnarangsin K, Chugh A, Suwanagool A, Guiot A, Madenci A, Walsh S, Ilg KJ, Gupta SK, Latchamsetty R, Bagwe S, Myles JD, Crawford T, Good E, Bogun F, Pelosi F Jr, Morady F, Oral H. Prevalence and predictors of complications of radiofrequency catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol 2011;22(6):626-31. Go to original source... Go to PubMed...
    17. Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study. Circulation 1994;89(2):724-30. Go to original source... Go to PubMed...
    18. Waligóra M, Tyrka A, Miszalski-Jamka T, Urbañczyk-Zawadzka M, Podolec P, Kopeæ G. Right atrium enlargement predicts clinically significant supraventricular arrhythmia in patients with pulmonary arterial hypertension. Heart Lung 2018;47(3):237-42. Go to original source... Go to PubMed...

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