Herzmedizin

Prevalence of stroke and mortality in patients with atrial tachycardia

A.-K. Kahle (Düsseldorf)1, F. Doldi (Münster)2, P. Foszcz (Hamburg)3, O. Anwar (Hamburg)3, A. Haas (Karlsruhe)4, M. Lemoine (Hamburg)5, J. Obergassel (Hamburg)6, F.-A. Alken (Düsseldorf)1, K. Scherschel (Düsseldorf)1, E. Zhu (Düsseldorf)1, A. Luik (Karlsruhe)4, A. Metzner (Hamburg)7, P. Kirchhof (Hamburg)8, S. Willems (Hamburg)3, L. Eckardt (Münster)2, C. Meyer (Düsseldorf)1
1Evangelisches Krankenhaus Düsseldorf Klinik für Kardiologie Düsseldorf, Deutschland; 2Universitätsklinikum Münster Klinik für Kardiologie II - Rhythmologie Münster, Deutschland; 3Asklepios Klinik St. Georg Kardiologie & internistische Intensivmedizin Hamburg, Deutschland; 4Städtisches Klinikum Karlsruhe gGmbH Med. IV, Schwerpunkt Kardiologie, Angiologie und Internistische Intensivmedizin Karlsruhe, Deutschland; 5Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland; 6Universitätsklinikum Hamburg-Eppendorf Klinik für Kardiologie Hamburg, Deutschland; 7Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie Hamburg, Deutschland; 8Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Lübeck, Deutschland
Background: Atrial tachycardias (AT) are increasingly observed in clinical practice. While catheter ablation has become the therapy of choice, outcome data in these patients are missing.

Aim: Here, we aimed to analyze the prevalence of stroke and all-cause death in patients with AT.

Methods: SATELLITE (Systematic Assessment of Treatment Effectiveness for Long-Term Management of Stable Atrial Tachycardia in Inpatient and Outpatient Environments) is a multicenter observational registry including patients undergoing catheter ablation or electrocardioversion for AT. In the present analysis, the prevalence of stroke and all-cause death in patients with AT as well as the characteristics of affected patients were assessed. Data acquisition started at the time of AT ablation or electrocardioversion.

Results: Among 1032 patients with AT (mean age 64.3±14.6 years, 53.5% male), 10 (1.0%) developed a stroke occurring 2.3±2.4 years (range 75–3224 days) after AT ablation or electrocardioversion (0.45 events/100 patient-years). They had a CHA2DS2-VA score of 2 (IQR 1–4) and were mostly female (6/10 patients). Among these patients, 5/10 had simultaneously diagnosed atrial fibrillation, 2/10 any structural heart disease and 5/10 underwent prior cardiac interventions (Fig. A). During catheter ablation, AT were left-sided in the majority of patients who developed a stroke (87.5%). Among all 1032 patients, 21 (2.0%) died mainly due to non-cardiac reasons (72.7%). This occurred 2.4±1.3 years (range 306–2271 days) after AT ablation or electrocardioversion (0.9 events/100 patient-years). Among these patients, 13/21 were female, 12/21 had atrial fibrillation, 5/21 had any structural heart disease and 12/21 underwent prior cardiac interventions (Fig. B).

Conclusion: Whereas the prevalence of stroke in patients with AT is low, the prevalence of all-cause death mainly due to non-cardiac reasons underlines the frequent multimorbidity of this cohort which should be considered especially for planning of ablation procedures.
 


Figure: Prevalence of stroke and mortality in patients with atrial tachycardia.
The prevalence of A, stroke and B, all-cause death as well as characteristics of affected patients with AT are illustrated. AF = atrial fibrillation; SHD = structural heart disease.

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