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Clinical predictors of heart block during atrioventricular nodal reentrant tachycardia ablation: A multicenter 18‐year experience

Title: Clinical predictors of heart block during atrioventricular nodal reentrant tachycardia ablation: A multicenter 18‐year experience
Authors: Makker, Parth; Saleh, Moussa; Vaishnav, Aditi S.; Coleman, Kristie M.; Beldner, Stuart; Ismail, Haisam; Sharma, Nikhil; Jadonath, Ram; Goldner, Bruce; Mitra, Raman; Epstein, Laurence; John, Roy; Mountantonakis, Stavros E.
Source: Journal of Cardiovascular Electrophysiology ; volume 32, issue 6, page 1658-1664 ; ISSN 1045-3873 1540-8167
Publisher Information: Wiley
Publication Year: 2021
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Background Catheter ablation is considered the first‐line treatment of symptomatic atrioventricular nodal reentrant tachycardia (AVNRT). It has been associated with a risk of heart block (HB) requiring a pacemaker. This study aims to determine potential clinical predictors of complete heart block as a result AVNRT ablation. Methods Consecutive patients undergoing catheter ablation for AVNRT from January 2001 to June 2019 at two tertiary hospitals were included. We defined ablation‐related HB as the unscheduled implantation of pacemaker within a month of the index procedure. Use of electroanatomic mapping (EAM), operator experience, inpatient status, age, sex, fluoroscopy time, baseline PR interval, and baseline HV interval was included in univariate and multivariate models to predict HB post ablation. Results In 1708 patients (56.4 ± 17.0 years, 61% females), acute procedural success was 97.1%. The overall incidence of HB was 1.3%. Multivariate analysis showed that age more than 70 (odds ratio [OR] 7.907, p ≤ .001, confidence interval [CI] 2.759–22.666), baseline PR ≥ 190 ms (OR 2.867, p = .026, CI 1.135–7.239) and no use of EAM (OR 0.306, p = .037, CI 0.101–0.032) were independent predictors of HB. Conclusion Although the incidence of HB post AVNRT ablation is generally low, patients can be further stratified using three simple predictors.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/jce.15037
Availability: https://doi.org/10.1111/jce.15037; https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.15037; https://onlinelibrary.wiley.com/doi/full-xml/10.1111/jce.15037
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.FC9E4902
Database: BASE