Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

Carlo de Asmundis; Lorenzo Marcon; Luigi Pannone; Domenico Giovanni Della Rocca; Dhanunjaya Lakkireddy; Thomas M Beaver; Chad R Brodt; Cinzia Monaco; Antonio Sorgente; Charles Audiat; Giampaolo Vetta; Robbert Ramak; Ingrid Overeinder; Rani Kronenberger; Gezim Bala; Alexandre Almorad; Erwin Ströker; Juan Sieira; Andrea Sarkozy; Pedro Brugada; Gian Battista Chierchia; Mark La Meir

doi:10.1016/j.hroo.2024.01.001

Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

Carlo de Asmundis, Lorenzo Marcon, Luigi Pannone, Domenico Giovanni Della Rocca, Dhanunjaya Lakkireddy, Thomas M Beaver, Chad R Brodt, Cinzia Monaco, Antonio Sorgente, Charles Audiat, Giampaolo Vetta, Robbert Ramak, Ingrid Overeinder, Rani Kronenberger, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Andrea Sarkozy, Pedro BrugadaGian Battista Chierchia, Mark La Meir

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Abstract

BACKGROUND: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).

OBJECTIVE: The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.

METHODS: All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.

RESULTS: A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank P < .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, P = .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, P < .001).

CONCLUSION: In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.

Original language	English
Pages (from-to)	137-144
Number of pages <span style="color:red"p> <font size="1.5"> ✽ </span> </font>	8
Journal	Heart rhythm O2
Volume	5
Issue number	2
DOIs	https://doi.org/10.1016/j.hroo.2024.01.001
Publication status	Published - Feb 2024

Bibliographical note

Funding Information:
Carlo de Asmundis has received research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips, and Acutus; and compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, LivaNova, Boston Scientific, AtriCure, Acutus Medical, and Daiichi Sankyo. Antonio Sorgente has received research grants from Daiichi Sankyo and Bayer; and speaker fees from Menarini and Bayer. Pedro Brugada has received compensation for teaching purposes from Biotronik. GBC has received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific, and Acutus Medical. Mark La Meir has served as a consultant for AtriCure. The remaining authors have nothing to disclose.

Publisher Copyright:
© 2024 Heart Rhythm Society

Keywords

Hybrid ablation
Inappropriate sinus node tachycardia
Pericarditis
Postural orthostatic sinus tachycardia
Sinus node
cardiac implantable electronic device
data analysis software
SPSS Statistics 23.0
acetylsalicylic acid
colchicine
ablation therapy
adult
article
cardioversion
disease activity
disease severity
echocardiography
electrocardiogram
female
follow up
heart left ventricle ejection fraction
heart rate
human
inferior cava vein
inflammatory bowel disease
pacemaker implantation
pericardial effusion
pericardiectomy
pericarditis
Pericarditis prophylactic therapy
postural orthostatic tachycardia syndrome
prophylaxis
psoriasis
pulmonary vein isolation
recurrence free survival
sinus node
sinus node sparing hybrid ablation
sinus tachycardia
superior cava vein
supraventricular tachycardia
survival analysis
systemic lupus erythematosus
thorax pain
thyroid disease

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de Asmundis, C., Marcon, L., Pannone, L., Della Rocca, D. G., Lakkireddy, D., Beaver, T. M., Brodt, C. R., Monaco, C., Sorgente, A., Audiat, C., Vetta, G., Ramak, R., Overeinder, I., Kronenberger, R., Bala, G., Almorad, A., Ströker, E., Sieira, J., Sarkozy, A., ... La Meir, M. (2024). Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. Heart rhythm O2, 5(2), 137-144. https://doi.org/10.1016/j.hroo.2024.01.001

de Asmundis, Carlo ; Marcon, Lorenzo ; Pannone, Luigi ; Della Rocca, Domenico Giovanni ; Lakkireddy, Dhanunjaya ; Beaver, Thomas M ; Brodt, Chad R ; Monaco, Cinzia ; Sorgente, Antonio ; Audiat, Charles ; Vetta, Giampaolo ; Ramak, Robbert ; Overeinder, Ingrid ; Kronenberger, Rani ; Bala, Gezim ; Almorad, Alexandre ; Ströker, Erwin ; Sieira, Juan ; Sarkozy, Andrea ; Brugada, Pedro ; Chierchia, Gian Battista ; La Meir, Mark. / Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. In: Heart rhythm O2. 2024 ; Vol. 5, No. 2. pp. 137-144.

@article{2237e639aa0945809e305e085db10c21,

title = "Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia",

abstract = "BACKGROUND: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).OBJECTIVE: The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.METHODS: All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.RESULTS: A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank P < .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, P = .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, P < .001).CONCLUSION: In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.",

keywords = "Hybrid ablation, Inappropriate sinus node tachycardia, Pericarditis, Postural orthostatic sinus tachycardia, Sinus node, cardiac implantable electronic device, data analysis software, SPSS Statistics 23.0, acetylsalicylic acid, colchicine, ablation therapy, adult, article, cardioversion, disease activity, disease severity, echocardiography, electrocardiogram, female, follow up, heart left ventricle ejection fraction, heart rate, human, inferior cava vein, inflammatory bowel disease, pacemaker implantation, pericardial effusion, pericardiectomy, pericarditis, Pericarditis prophylactic therapy, postural orthostatic tachycardia syndrome, prophylaxis, psoriasis, pulmonary vein isolation, recurrence free survival, sinus node, sinus node sparing hybrid ablation, sinus tachycardia, superior cava vein, supraventricular tachycardia, survival analysis, systemic lupus erythematosus, thorax pain, thyroid disease",

author = "{de Asmundis}, Carlo and Lorenzo Marcon and Luigi Pannone and {Della Rocca}, {Domenico Giovanni} and Dhanunjaya Lakkireddy and Beaver, {Thomas M} and Brodt, {Chad R} and Cinzia Monaco and Antonio Sorgente and Charles Audiat and Giampaolo Vetta and Robbert Ramak and Ingrid Overeinder and Rani Kronenberger and Gezim Bala and Alexandre Almorad and Erwin Str{\"o}ker and Juan Sieira and Andrea Sarkozy and Pedro Brugada and Chierchia, {Gian Battista} and {La Meir}, Mark",

note = "Funding Information: Carlo de Asmundis has received research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips, and Acutus; and compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, LivaNova, Boston Scientific, AtriCure, Acutus Medical, and Daiichi Sankyo. Antonio Sorgente has received research grants from Daiichi Sankyo and Bayer; and speaker fees from Menarini and Bayer. Pedro Brugada has received compensation for teaching purposes from Biotronik. GBC has received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific, and Acutus Medical. Mark La Meir has served as a consultant for AtriCure. The remaining authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2024 Heart Rhythm Society",

year = "2024",

month = feb,

doi = "10.1016/j.hroo.2024.01.001",

language = "English",

volume = "5",

pages = "137--144",

journal = "Heart rhythm O2",

issn = "2666-5018",

publisher = "New York: Elsevier Inc.",

number = "2",

}

de Asmundis, C , Marcon, L , Pannone, L , Della Rocca, DG, Lakkireddy, D, Beaver, TM, Brodt, CR, Monaco, C , Sorgente, A , Audiat, C , Vetta, G, Ramak, R, Overeinder, I , Kronenberger, R , Bala, G , Almorad, A , Ströker, E, Sieira, J, Sarkozy, A , Brugada, P , Chierchia, GB & La Meir, M 2024, 'Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia', Heart rhythm O2, vol. 5, no. 2, pp. 137-144. https://doi.org/10.1016/j.hroo.2024.01.001

Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. / de Asmundis, Carlo ; Marcon, Lorenzo ; Pannone, Luigi ; Della Rocca, Domenico Giovanni; Lakkireddy, Dhanunjaya; Beaver, Thomas M; Brodt, Chad R; Monaco, Cinzia ; Sorgente, Antonio ; Audiat, Charles ; Vetta, Giampaolo; Ramak, Robbert; Overeinder, Ingrid ; Kronenberger, Rani ; Bala, Gezim ; Almorad, Alexandre ; Ströker, Erwin; Sieira, Juan; Sarkozy, Andrea ; Brugada, Pedro ; Chierchia, Gian Battista ; La Meir, Mark.

In: Heart rhythm O2, Vol. 5, No. 2, 02.2024, p. 137-144.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

AU - de Asmundis, Carlo

AU - Marcon, Lorenzo

AU - Pannone, Luigi

AU - Della Rocca, Domenico Giovanni

AU - Lakkireddy, Dhanunjaya

AU - Beaver, Thomas M

AU - Brodt, Chad R

AU - Monaco, Cinzia

AU - Sorgente, Antonio

AU - Audiat, Charles

AU - Vetta, Giampaolo

AU - Ramak, Robbert

AU - Overeinder, Ingrid

AU - Kronenberger, Rani

AU - Bala, Gezim

AU - Almorad, Alexandre

AU - Ströker, Erwin

AU - Sieira, Juan

AU - Sarkozy, Andrea

AU - Brugada, Pedro

AU - Chierchia, Gian Battista

AU - La Meir, Mark

N1 - Funding Information: Carlo de Asmundis has received research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips, and Acutus; and compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, LivaNova, Boston Scientific, AtriCure, Acutus Medical, and Daiichi Sankyo. Antonio Sorgente has received research grants from Daiichi Sankyo and Bayer; and speaker fees from Menarini and Bayer. Pedro Brugada has received compensation for teaching purposes from Biotronik. GBC has received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific, and Acutus Medical. Mark La Meir has served as a consultant for AtriCure. The remaining authors have nothing to disclose. Publisher Copyright: © 2024 Heart Rhythm Society

PY - 2024/2

Y1 - 2024/2

N2 - BACKGROUND: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).OBJECTIVE: The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.METHODS: All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.RESULTS: A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank P < .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, P = .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, P < .001).CONCLUSION: In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.

AB - BACKGROUND: Pericarditis is the most common complication following hybrid sinus node-sparing ablation for inappropriate sinus tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS).OBJECTIVE: The study sought to evaluate the association of prophylaxis therapy on the risk of symptomatic pericarditis following hybrid IST/POTS ablation.METHODS: All consecutive patients undergoing to hybrid ablation of symptomatic IST/POTS refractory or intolerant to drugs were retrospectively analyzed. Pharmacological prophylaxis therapy was based on acetylsalicylic acid and colchicine started on the day of the ablation and continued for at least 3 months. The primary endpoint was occurrence of symptomatic pericarditis. The secondary endpoint was occurrence of pericarditis-related complications, including the following: duration of pericarditis >3 months, hospitalization for pericarditis, postpericardiectomy pleuro-pericarditis, and pericardiectomy.RESULTS: A total of 220 patients undergone to hybrid IST/POTS ablation were included and 44 (20%) underwent prophylaxis therapy. Pericarditis occurred in 101 (45.9%) patients, with 97 (96%) in the first 5 days. At survival analysis, prophylaxis was associated with higher rate of freedom from pericarditis (81.9% vs 47.2%, log-rank P < .001). Pericarditis-related complications were low, occurring in 7 (3.2%) patients. There was no difference in pericarditis-related complications between the patients who underwent prophylaxis therapy and patients who did not. At Cox multivariate analysis, predictors of pericarditis were IST (vs POTS) (hazard ratio 0.61, 95% confidence interval0.39-0.99, P = .04) and prophylaxis therapy (hazard ratio 0.27, 95% confidence interval 0.13-0.55, P < .001).CONCLUSION: In a large cohort of patients undergoing hybrid ablation for IST/POTS, a prophylaxis therapy with acetylsalicylic acid and colchicine was associated with a lower rate of symptomatic pericarditis.

KW - Hybrid ablation

KW - Inappropriate sinus node tachycardia

KW - Pericarditis

KW - Postural orthostatic sinus tachycardia

KW - Sinus node

KW - cardiac implantable electronic device

KW - data analysis software

KW - SPSS Statistics 23.0

KW - acetylsalicylic acid

KW - colchicine

KW - ablation therapy

KW - adult

KW - article

KW - cardioversion

KW - disease activity

KW - disease severity

KW - echocardiography

KW - electrocardiogram

KW - female

KW - follow up

KW - heart left ventricle ejection fraction

KW - heart rate

KW - human

KW - inferior cava vein

KW - inflammatory bowel disease

KW - pacemaker implantation

KW - pericardial effusion

KW - pericardiectomy

KW - pericarditis

KW - Pericarditis prophylactic therapy

KW - postural orthostatic tachycardia syndrome

KW - prophylaxis

KW - psoriasis

KW - pulmonary vein isolation

KW - recurrence free survival

KW - sinus node

KW - sinus node sparing hybrid ablation

KW - sinus tachycardia

KW - superior cava vein

KW - supraventricular tachycardia

KW - survival analysis

KW - systemic lupus erythematosus

KW - thorax pain

KW - thyroid disease

UR - http://www.scopus.com/inward/record.url?scp=85184021195&partnerID=8YFLogxK

U2 - 10.1016/j.hroo.2024.01.001

DO - 10.1016/j.hroo.2024.01.001

M3 - Article

C2 - 38545325

VL - 5

SP - 137

EP - 144

JO - Heart rhythm O2

JF - Heart rhythm O2

SN - 2666-5018

IS - 2

ER -

Pericarditis prophylactic therapy after sinus mode–sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

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