High incidence of atrial fibrillation after successful catheter ablation of atrioventricular nodal reentrant tachycardia: a 15.5-year follow-up

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of supraventricular tachycardia. Slow pathway (SP) ablation is the treatment of choice with a high acute success rate and a negligible periprocedural risk. However, long-term outcome data are scarce. The aim of this study was to assess long-term outcome and arrhythmia free survival after SP ablation. In this study, 534 consecutive patients with AVNRT, who underwent SP ablation between 1994 and 1999 were included. During a mean follow-up of 15.5 years, 101(18.9%) patients died unrelated to the procedure or any arrhythmia. Data were collected by completing a questionnaire and/or contacting patients. Clinical information was obtained from 329 patients (61.6%) who constitute the final study cohort. During the electrophysiological study, sustained 1:1 slow AV nodal pathway conduction was eliminated in all patients. Recurrence of AVNRT was documented in 9 patients (2.7%), among those 7 patients underwent a successful repeat ablation procedure. New-onset atrial fibrillation (AF) was documented in 39 patients (11.9%) during follow-up. Pre-existing arterial hypertension (odds ratio 2.61, 95%CI 1.14-5.97, p = 0.023), age (odds ratio 1.05, 95%CI 1.02-1.09, p = 0.003) and the postinterventional AH interval (odds ratio 1.02, 95% CI 1.00-1.04, p = 0.038) predicted the occurrence of AF. The present long-term observational study after successful SP ablation of AVNRT confirms its clinical value reflected by low recurrence and complication rates. The unexpectedly high incidence of new-onset AF (11.9%) may impact long-term follow-up and requires further clinical attention.