TY - JOUR
T1 - Impact of Tricuspid Regurgitation on the Success of Atrioventricular Node Ablation for Rate Control in Patients With Atrial Fibrillation
T2 - The Node Blast Study
AU - Reddy, Yeruva Madhu
AU - Gunda, Sampath
AU - Vallakati, Ajay
AU - Kanmanthareddy, Arun
AU - Pillarisetti, Jayasree
AU - Atkins, Donita
AU - Bommana, Sudharani
AU - Emert, Martin P.
AU - Pimentel, Rhea
AU - Dendi, Raghuveer
AU - Berenbom, Loren D.
AU - Lakkireddy, Dhanunjaya
N1 - Funding Information:
Dr. Emert is a consultant to Medtronic. RP received modest speaker honorarium from St Jude Medical. Dr. Lakkireddy received modest speaker honorarium and research grant from St Jude Medical. The other authors have no conflicts to report.
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/9/15
Y1 - 2015/9/15
N2 - Atrioventricular node (AVN) ablation is an effective treatment for symptomatic patients with atrial arrhythmias who are refractory to rhythm and rate control strategies where optimal ventricular rate control is desired. There are limited data on the predictors of failure of AVN ablation. Our objective was to identify the predictors of failure of AVN ablation. This is an observational single-center study of consecutive patients who underwent AVN ablation in a large academic center. Baseline characteristics, procedural variables, and outcomes of AVN ablation were collected. AVN "ablation failure" was defined as resumption of AVN conduction resulting in recurrence of either rapid ventricular response or suboptimal biventricular pacing. A total of 247 patients drug refractory AF who underwent AVN ablation at our center with a mean age of 71 ± 12 years with 46% being males were included. Ablation failure was seen in 11 (4.5%) patients. There were no statistical differences between patients with "ablation failure" versus "ablation success" in any of the baseline clinical variables. Patients with moderate-to-severe tricuspid regurgitation (TR) were much more likely to have ablation failure than those with ablation success (8 [73%] vs 65 [27%]; p = 0.003). All 11 patients with ablation failure had a successful redo procedure, 9 with right and 2 with the left sided approach. On multivariate analysis, presence of moderate-to-severe TR was found to be the only predictor of failure of AVN ablation (odds ratio 9.1, confidence interval 1.99 to 42.22, p = 0.004). In conclusion, moderate-to-severe TR is a strong and independent predictor of failure of AVN ablation.
AB - Atrioventricular node (AVN) ablation is an effective treatment for symptomatic patients with atrial arrhythmias who are refractory to rhythm and rate control strategies where optimal ventricular rate control is desired. There are limited data on the predictors of failure of AVN ablation. Our objective was to identify the predictors of failure of AVN ablation. This is an observational single-center study of consecutive patients who underwent AVN ablation in a large academic center. Baseline characteristics, procedural variables, and outcomes of AVN ablation were collected. AVN "ablation failure" was defined as resumption of AVN conduction resulting in recurrence of either rapid ventricular response or suboptimal biventricular pacing. A total of 247 patients drug refractory AF who underwent AVN ablation at our center with a mean age of 71 ± 12 years with 46% being males were included. Ablation failure was seen in 11 (4.5%) patients. There were no statistical differences between patients with "ablation failure" versus "ablation success" in any of the baseline clinical variables. Patients with moderate-to-severe tricuspid regurgitation (TR) were much more likely to have ablation failure than those with ablation success (8 [73%] vs 65 [27%]; p = 0.003). All 11 patients with ablation failure had a successful redo procedure, 9 with right and 2 with the left sided approach. On multivariate analysis, presence of moderate-to-severe TR was found to be the only predictor of failure of AVN ablation (odds ratio 9.1, confidence interval 1.99 to 42.22, p = 0.004). In conclusion, moderate-to-severe TR is a strong and independent predictor of failure of AVN ablation.
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U2 - 10.1016/j.amjcard.2015.06.017
DO - 10.1016/j.amjcard.2015.06.017
M3 - Article
C2 - 26174606
AN - SCOPUS:84940584247
VL - 116
SP - 900
EP - 903
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 6
M1 - 21245
ER -