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Clinical predictors of heart block during atrioventricular nodal reentrant tachycardia ablation: A multicenter 18‐year experience
Author(s) -
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.
Publication year - 2021
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.15037
Subject(s) - medicine , ablation , catheter ablation , tachycardia , cardiology , odds ratio , confidence interval , atrioventricular block , univariate analysis , heart block , incidence (geometry) , radiofrequency ablation , supraventricular tachycardia , multivariate analysis , electrocardiography , physics , optics
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.