Redo procedures after sinus node 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:10.1093/europace/euad373

Redo procedures after sinus node 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

AIMS: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures.

METHODS AND RESULTS: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure.

CONCLUSION: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.

Original language	English
Article number	euad373
Number of pages	11
Journal	Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Volume	26
Issue number	1
DOIs	https://doi.org/10.1093/europace/euad373
Publication status	Published - 28 Dec 2023

Bibliographical note

Keywords

Humans
Tachycardia, Sinus/diagnosis
Sinoatrial Node
Catheter Ablation/adverse effects
Heart Rate

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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. (2023). Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, 26(1), [euad373]. https://doi.org/10.1093/europace/euad373

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. / Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. In: Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 2023 ; Vol. 26, No. 1.

@article{1165a73280694d618d2613452a37364f,

title = "Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia",

abstract = "AIMS: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures.METHODS AND RESULTS: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure.CONCLUSION: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.",

keywords = "Humans, Tachycardia, Sinus/diagnosis, Sinoatrial Node, Catheter Ablation/adverse effects, Heart Rate",

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 = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2023",

month = dec,

day = "28",

doi = "10.1093/europace/euad373",

language = "English",

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journal = "Europace",

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Redo procedures after sinus node 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: Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology, Vol. 26, No. 1, euad373, 28.12.2023.

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

TY - JOUR

T1 - Redo procedures after sinus node 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

PY - 2023/12/28

Y1 - 2023/12/28

N2 - AIMS: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures.METHODS AND RESULTS: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure.CONCLUSION: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.

AB - AIMS: A novel sinus node (SN) sparing hybrid ablation for inappropriate sinus node tachycardia (IST)/postural orthostatic tachycardia syndrome (POTS) has been demonstrated to be an effective and safe therapeutic option in patients with symptomatic drug-resistant IST/POTS. The aim of this study was to evaluate the long-term rate of redo procedures after hybrid IST ablation and procedural strategy, outcomes and safety of redo procedures.METHODS AND RESULTS: All consecutive patients from 2015 to 2023 were prospectively enrolled in the UZ Brussel monocentric IST/POTS registry. They were analysed if the following inclusion criteria were fulfilled: 1) diagnosis of IST or POTS, 2) symptomatic IST/POTS refractory or intolerant to drugs, and 3) hybrid SN sparing ablation performed. The primary endpoint was redo procedure. The primary safety endpoint was pacemaker (PM) implantation. A total of 220 patients undergone to hybrid IST ablation were included, 185 patients (84.1%) were treated for IST and 61 patients (27.7%) for POTS.After a follow-up of 73.3 ± 16.2 months, 34 patients (15.4%) underwent a redo. A total of 23 patients (67.6%) had a redo for IST recurrence and 11 patients (32.4%) for other arrhythmias. Pacemaker implantation was performed in 21 patients (9.5%). Nine patients (4.1%) had no redo procedure and experienced sick sinus syndrome requiring a PM. Twelve patients (5.4%) received a PM as a shared therapeutic choice combined with SN ablation procedure.CONCLUSION: In a large cohort of patients the long-term free survival from redo procedure after hybrid IST ablation was 84.6% with a low PM implantation rate.

KW - Humans

KW - Tachycardia, Sinus/diagnosis

KW - Sinoatrial Node

KW - Catheter Ablation/adverse effects

KW - Heart Rate

UR - http://www.scopus.com/inward/record.url?scp=85182028005&partnerID=8YFLogxK

U2 - 10.1093/europace/euad373

DO - 10.1093/europace/euad373

M3 - Article

C2 - 38155611

VL - 26

JO - Europace

JF - Europace

SN - 1099-5129

IS - 1

M1 - euad373

ER -

de Asmundis C , Marcon L , Pannone L , Della Rocca DG, Lakkireddy D, Beaver TM et al. Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia. Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 2023 Dec 28;26(1). euad373. https://doi.org/10.1093/europace/euad373

Redo procedures after sinus node sparing hybrid ablation for inappropriate sinus tachycardia/postural orthostatic sinus tachycardia

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