| Ablation of Atrioventricular Nodal Reentrant Tachycardia in the Elderly: Results from the German Ablation Registry. | |
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MedLine Citation:
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PMID: 21315834 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Catheter ablation (CA) is considered the treatment of choice for patients with atrioventricular nodal reentrant tachycardia (AVNRT). However, there is a tendency to avoid CA in the elderly because of a presumed increased risk of periprocedural atrioventricular (AV) nodal block. OBJECTIVE: The purpose of this prospective registry was to assess age-related differences in efficacy and safety of CA within a large population suffering from AVNRT. METHODS: 3234 consecutive patients from 48 German trial centers who underwent CA of AVNRT between March 2007 and May 2010 were enrolled in this study. The cohort was divided into three age groups: < 50 years (Group 1, n = 1268 (39.2%); median age = 40 (30.0-45.0) years, 74.1% women), 50-75 years old (Group 2, n = 1707 (52.8%); 63.0 (58.0-69.0) years, 63.0% women) and > 75 years old (Group 3, n = 259 (8.0%); 79.0 (77.0-82.0) years, 50.6% women). RESULTS: CA was performed with radiofrequency current (RFC) in 97.7% and cryoablation technology in 2.3% of all cases. No differences were observed between the three groups with regard to primary CA success rate (98.7% vs. 98.8 % vs. 98.5%, p = 0.92) and overall procedure duration (75.0 min. (50.0-105.0), p = 0.93). Hemodynamically stable pericardial effusion occurred in five Group 2 (0.3%) and two Group 3 (0.8%) patients, but in none of the Group 1 (p < 0.05) patients. Complete atrioventricular (AV) block requiring permanent pacemaker implantation occurred in two patients in Group 1 (0.2%), six patients in Group 2 (0.4%), but none in Group 3 (p = 0.41). During a median follow-up period of 511.5 days (396.0-771.0), AVNRT recurrence occurred in 5.7% of all patients. Patients > 75 years (Group 3) had a significantly longer hospital stay (3.0 days (2.0-5.0)) compared to Group 1 (2.0 days (1.0-2.0)) or Group 2 (2.0 days (1.0-3.0)) patients (p < 0.0001). CONCLUSION: Catheter ablation of AVNRT is highly effective and safe and does not pose an increased risk for complete AV block in patients over 75 years of age despite a higher prevalence of structural heart disease. Anti-arrhythmic drug therapy is often ineffective in this age group; thus, catheter ablation for AVNRT should be considered the preferred treatment even in elderly patients. |
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Authors:
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Boris A Hoffmann; Johannes Brachmann; Dietrich Andresen; Lars Eckardt; Ellen Hoffmann; Karl-Heinz Kuck; Burghard Schumacher; Stefan G Spitzer; Petra Schirdewahn; Jürgen Tebbenjohanns; Martin Horack; Jochen Senges; Tushar V Salukhe; Thomas Rostock; Stephan Willems |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-9 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: - ISSN: 1556-3871 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011. Published by Elsevier Inc. |
Affiliation:
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University Heart Center, Department of Cardiology/Electrophysiology, Hamburg, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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