Long-term efficacy of empirical slow pathway ablation in non-inducible and suspected atrioventricular nodal reentry tachycardia

Background The empirical slow pathway ablation (ESPA) is often applied to non-inducible and suspected atrioventricular nodal reentrant tachycardia (AVNRT) patients. The long-term efficacy of ESPA in these patients is not entirely clear. Methods From January 2005 through December 2013, all patients who underwent slow pathway ablation were evaluated. Based on whether AVNRT could be induced, patients were divided into group A (AVNRT inducible) and group B (AVNRT non-inducible). Telephone communication, letter questionnaire and clinic visit were conducted for long-term follow-up, Recurrence was based on symptoms and/or ECG documentation. Results 622 patients underwent slow pathway ablation (median age 48 years, 56.8% female) were included in the study. 488 patients were classified into group A and 134 patients into group B. In a median follow-up of 31 months, the recurrence rate was similar between group A (7.4%) and group B (9.0%) (P > 0.05), the recurrence rate due to supraventricular tachycardia (SVT) and other arrhythmias was also similar between the groups (P > 0.05). In group B, the recurrence rate of patients without tachycardia ECG documentation before ablation was higher than those with tachycardia ECG documentation (P = 0.033). Logistic regression analysis showed that no tachycardia ECG documentation before ablation was a significant prognostic predictor for recurrence (P = 0.019). One major complication occurred in group A and none in group B. Conclusion ESPA can be performed safely and effectively in non-inducible and suspected AVNRT patients with good long-term results, no tachycardia ECG documentation before ablation is predictive for recurrence in these patients.