Atrial Fibrillation Inducibility After Ablation of Paroxysmal Supraventricular Tachycardia

Data on the inducibility of atrial fibrillation (AF) following supraventricular tachycardia (SVT) ablation in patients without prior history of AF are limited. This study aims to identify features associated with inducible AF and the subsequent development of clinical AF in patients who undergo SVT ablation.

This prospective study enrolled patients who underwent electrophysiology study and SVT ablation. AF inducibility testing post ablation utilized decremental atrial burst pacing, employing the same protocol that previously had been demonstrated to have clinical significance following pulmonary vein isolation. AF was assessed clinically as well as through 12-lead electrocardiogram recordings and ambulatory Holter recordings.

A total of 152 patients who underwent an SVT ablation were evaluated. The median age was 53 years (range: 18-90); 87 patients were female (57.2%). Atrioventricular nodal reentrant tachycardia was diagnosed in 112 of the patients (73.6%), and 40 patients (26.3%) exhibited arrhythmias related to an accessory pathway. AF was induced in 31 patients (20.4%) during the induction protocol. Among patients with inducible AF, 79% spontaneously converted to sinus rhythm, and the rest were managed with cardioversion. During a median follow-up period of 514 ± 287 days, 6 patients (3.9%) developed clinical AF. Inducible AF at the time of the SVT procedure was associated with the development of clinical AF (odds ratio = 8.81, 95% confidence interval 1.53-50.63; P = 0.01).

A significant proportion of patients undergoing SVT ablation have inducible AF, but only a few have clinical AF in the first 2 years of follow-up. Inducible AF after SVT ablation predicts future AF.