Persistence of Palpitations After Slow Pathway Modification for AVNRT in Young People

Thomas Carberry*, Lauren C. Balmert, Sabrina Stanley, Ahmad Sami Chaouki, Lajja Desai, Sabrina Tsao, Kendra Ward, Gregory Webster

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Symptoms are the most common indication for ablation in children with atrioventricular nodal reentrant tachycardia (AVNRT). After the procedure, patients may continue to report palpitations. The objective of this study was to quantify the risk and duration of palpitations after pediatric slow pathway modification as well as demographic and technical associations. This was a retrospective review of consecutive patients at a pediatric center who underwent slow pathway modification for AVNRT from 2012 to 2018. Patients with a prior ablation attempt or congenital heart disease were excluded. Palpitations were documented in 35% of patients after ablation. Neither post-ablation echo beats nor other evidence of residual dual AV nodal physiology were associated with a higher risk of post-ablation palpitations. Of the 35 patients with post-ablation palpitations, the median time to resolution of palpitations was 48 months. Acute procedural success was achieved in all 100 cases. There were two recurrences of AVNRT during long-term follow-up and one instance of ectopic atrial tachycardia (3% SVT recurrence). Palpitations after AVNRT ablation occurred in approximately one-third of cases, despite a low recurrence of true arrhythmia. Prior to ablation, patients and families should be counseled that post-ablation palpitations are common and AVNRT recurrence is rare.

Original languageEnglish (US)
Pages (from-to)590-596
Number of pages7
JournalPediatric cardiology
Volume42
Issue number3
DOIs
StatePublished - Mar 2021

Keywords

  • AVNRT
  • Ablation
  • Cryoablation
  • Palpitations
  • SVT

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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