Objective: To analyze and compare long term follow up of ablation of incessant supraventricular tachycardias in patients after open heart surgery and after catheter ablation.
Materials and Methods: From January 2007 to August 2012 we performed 32 catheter ablation procedures to patients with supraventricular incessant tachycardias. We studied long term follow up of 28 patients, mean age 39 + 27 years, who had incessant atrial tachycardias due to open heart surgery or catheter ablation in the past. Patients were divided into two groups: in the first group (12 patients) were included patients who had undergone open heart surgery in the past, in the second group (14 patients) were included patients who had had catheter ablation before. Catheter ablations of all incessant tachycardias were performed by using 3-D navigation system. Mean follow up period 20 + 14 months.
Results: In a group of patients after open heart surgery sinus rhythm was restored in all patients. 10 patients experienced only one catheter ablation, 2 patients had recurrences in other supraventricular tachycardias (AV nodal reentrant tachycardia and focal right atrial tachycardia respectively) after the first ablation. And after the second procedure one patient was on sinus rhythm, in the second case dual chamber pacemaker was implanted due to transient symptomatic AV block 2 degree.
In the second group sinus rhythm was restored in 10 patients. Two patients of this group insisted on pacemaker implantation and AV node ablation after two or three unsuccessful catheter ablations and highly symptomatic tachycardias. In two other patients pacemakers were implanted in combination with AV node ablation due to recurrences of AF after incessant tachycardias elimination.
Conclusions: Catheter ablation of incessant tachycardias wether after open heart surgery or after catheter ablation is very effective method of treatment. In our study these two groups of patients are very different (all incessant tachycardias of the second group were recurrences of atrial fibrillation ablation and in 100% of cases localized in the left atrium, in the first group 7 tachycardias were right sided) and this can be the rationale of different effectiveness of ablation.