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Long-term survival after closed-chest His-bundle ablation with DC shock for supraventricular arrhythmias: a 10-year
F Poquet1, L Gencel, P Lemétayer
1Hôpital Cardiologique Haut Lévêque, Bordeau-Pessac, France.
Insights
This study analyzed survival in 317 patients undergoing His bundle ablation for supraventricular arrhythmias. The overall mortality rate was 17.3%, with common causes of death including heart failure and sudden cardiac events.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Supraventricular arrhythmias pose significant health risks.
- His bundle ablation is a therapeutic option for refractory arrhythmias.
- Understanding long-term survival post-ablation is crucial for patient management.
Purpose of the Study:
- To evaluate the survival rates and outcomes of patients who underwent closed-chest His bundle ablation.
- To identify factors influencing mortality after this procedure.
Main Methods:
- Retrospective analysis of 317 consecutive patients undergoing His bundle ablation.
- Data collected over a 10-year period (May 1982-December 1992).
- Analysis included patient demographics, underlying heart disease, arrhythmias, and causes of death.
Main Results:
- 17.3% of patients (54/317) died during the follow-up period.
- Mean survival after ablation for deceased patients was 30.5 months.
- Common comorbidities included hypertension and cardiomyopathy; atrial fibrillation was the most frequent arrhythmia.
Conclusions:
- Closed-chest His bundle ablation demonstrated a 17.3% mortality rate in this cohort.
- Survival outcomes are influenced by pre-existing cardiac conditions and the type of arrhythmia treated.
- Further research may refine patient selection and post-ablation care.
Abstract:
Survival after closed-chest ablation of His bundle with DC shock for supraventricular arrhythmias was analyzed for a 10-year period (May 1982-December 1992) with 317 consecutive patients (167 males, 150 females; mean age 66 years; range 33-93 years). Of these, 54 patients died (17.3%) and 5 were lost to follow-up. The mean age at ablation was 70.3 +/- 8.3 years with a range of 49-93 years. Of those who died, the mean survival was 30.5 +/- 28.6 months with a range of 36 hours to 120 months; the diagnosis of heart disease was: hypertension (n = 14), cardiomyopathy (n = 8), ischemic (n = 7), valvular (n = 6), cor pulmonale (n = 3), valvular and ischemic (n = 2), hypertension and ischemic (n = 1), miscellaneous (n = 3), and none (n = 10). Of the patients who died after ablation, the arrhythmias at the time of the ablation were atrial fibrillation (AF; n = 33), sick sinus syndrome (n = 5), atrial flutter (AFL; n = 4), paroxysmal AV junctional tachycardia (PAVJT; n = 4), AF + AFL (n = 4), atrial tachycardia (n = 2), PAVJT + AFL (n = 1), and AF +AFL + atrial tachycardia (n = 1). Death was sudden in 13 patients (25%), due to heart failure in 10 (19.2%), myocardial infarction in 4 (7.7%), stroke in 4 (7.7%), aortic vascular accident in 3 (5.8%), miscellaneous in 18 (34.6%), and undetermined in 2.(ABSTRACT TRUNCATED AT 250 WORDS)