Outcomes of supraventricular tachycardia ablation: Results from the Singapore ablation and cardiac devices registry outcomes of supraventricular tachycardia ablation.

BACKGROUND The Singapore Cardiac Databank was designed to monitor the performance and outcomes of catheter ablation. We investigated the outcomes of paroxysmal supraventricular tachycardia (PSVT)-ablation in a prospective, nationwide, cohort study. METHODS Atrioventricular nodal re-entrant tachycardia (AVNRT), atrioventricular re-entry tachycardia (AVRT) or atrial tachycardia (AT)-ablations in Singapore from 2010 to 2018 were studied. Outcomes include acute success, periprocedural-complications, post-operative pacing requirement, arrhythmic recurrence and one-year all-cause mortality. RESULTS Among 2,260 patients (mean age 45±18years, 50% female, 57% AVNRT, 37% AVRT, 6% AT), overall acute success rates of PSVT-ablation was 98.4% and increased in order of AT, AVRT and AVNRT (p<0.001). Periprocedural cardiac tamponade occurred in 2 AVRT patients. A total of 15 pacemakers (6 within first 30-days, 9 after 30-days) were implanted (7 AV block, 8 sinus node dysfunction), with the highest incidence of pacemaker implantation after AT-ablation (5% vs 0.6% AVNRT vs 0.1% AVRT, p<0.001). Repeat ablations (0.9% AVNRT, 7% AVRT, 4% AT, p<0.001) were performed in 78 (3.5%) patients and 13 (0.6%) patients died within a year of ablation. Among outcomes considered adjusting for age, sex, PSVT-type and procedure-time, AT was independently associated with 6-fold increased odds of total (adjusted odds ratio[AOR] 6.32, 95% confidence interval [CI] 1.95-20.53) and late (AOR 6.38, 95% CI 1.39-29.29) pacemaker implantation, while AVRT was associated with higher arrhythmic recurrence with repeat ablations (AOR 4.72, 95% CI 2.36-9.44) compared to AVNRT. CONCLUSIONS Contemporary PSVT ablation is safe with high acute success rates. Long-term outcomes differed by nature of the PSVT. This article is protected by copyright. All rights reserved.