Incidence of atrial fibrillation in patients with atrioventricular nodal re-entrant tachycardia and its association with long-term outcome

Gesa von Olshausen, MD; Nikola Drca, MD, PhD; Astrid Paul-Nordin, MD, PhD; Tara Bourke, MD; Hamid Bastani, MD, PhD; Serkan Saygi, MD; Emma Svennberg, MD, PhD; Finn Åkerström, MD; Ott Saluveer, MD, PhD; Mats Jensen-Urstad, MD, PhD; Frieder Braunschweig, MD, PhD

Heart Rhythm O2 (Aug 2024)

Incidence of atrial fibrillation in patients with atrioventricular nodal re-entrant tachycardia and its association with long-term outcome

Gesa von Olshausen, MD,
Nikola Drca, MD, PhD,
Astrid Paul-Nordin, MD, PhD,
Tara Bourke, MD,
Hamid Bastani, MD, PhD,
Serkan Saygi, MD,
Emma Svennberg, MD, PhD,
Finn Åkerström, MD,
Ott Saluveer, MD, PhD,
Mats Jensen-Urstad, MD, PhD,
Frieder Braunschweig, MD, PhD

Affiliations

Gesa von Olshausen, MD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Medical Department I (Cardiology, Angiology, Pneumology), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Address reprint requests and correspondence: Dr Gesa von Olshausen, Klinik und Poliklinik für Innere Medizin I, Kardiologie, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Straße 22, 81675 Munich, Germany.
Nikola Drca, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Astrid Paul-Nordin, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Tara Bourke, MD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Hamid Bastani, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Serkan Saygi, MD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Emma Svennberg, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Finn Åkerström, MD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Ott Saluveer, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Mats Jensen-Urstad, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
Frieder Braunschweig, MD, PhD: Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden; Heart and Lung Disease Unit, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden

Journal volume & issue: Vol. 5, no. 8
pp. 538 – 542

Abstract

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Background: Atrioventricular nodal re-entrant tachycardia (AVNRT) is the most common paroxysmal supraventricular tachycardia. We sought to investigate the incidence of atrial fibrillation in patients with electrophysiologically confirmed/ablated AVNRT and its association with transient ischemic attack (TIA)/stroke as well as mortality during long-term follow-up. Methods: From the Karolinska Ablation Registry, 2855 consecutive patients with a first-time ablation for AVNRT between 2005 and 2018 were analyzed. Results: Patients were 52.1 ± 15.9 years old and 59.3% were women. During follow-up of up to 10 years (median 6.0 years; interquartile range 3.3 to 9.2 years), new onset or recurrence of atrial fibrillation occurred in 317 (11.1%) patients (incidence rate 19 cases per 1000 person-years). Excluding those with history of atrial fibrillation, new onset of atrial fibrillation occurred in 153 (6.1%) patients. In multivariable analysis, history of atrial fibrillation, arterial hypertension, history of TIA/stroke, and heart failure remained independently associated with new onset or recurrence of atrial fibrillation during follow-up. Death of any cause and TIA/stroke occurred in 141 (4.9%) patients and 107 (3.7%) patients, respectively. In multivariable analysis, occurrence of atrial fibrillation during follow-up remained independently associated with both outcomes. The prevalence of atrial fibrillation according to age at the end of follow-up was high among young patients (<60 years of age: 12.7%; 60–69 years of age: 10.6%). Conclusion: In this large cohort of patients with diagnosed AVNRT, the incidence of atrial fibrillation was high (11.1%) during long-term follow-up. Occurrence of atrial fibrillation during follow-up remained independently associated with death for any cause as well as with TIA/stroke. Therefore, a closer monitoring for atrial fibrillation in patients with AVNRT including those at young age is advisable.

Published in Heart Rhythm O2

ISSN: 2666-5018 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/heart-rhythm-o2

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