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Long-term outcome after catheter ablation for atrial tachycardia

https://doi.org/10.1007/s00392-025-02625-4

Ann-Kathrin 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)5, P. Kirchhof (Hamburg)7, 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 mit Schwerpunkt Elektrophysiologie Hamburg, Deutschland; 6Universitätsklinikum Hamburg-Eppendorf Klinik für Kardiologie Hamburg, Deutschland; 7Universitäres Herz- und Gefäßzentrum Hamburg Klinik für Kardiologie Hamburg, Deutschland

 

Background: Catheter ablation has become the most effective therapy to maintain sinus rhythm in patients with atrial tachycardia (AT), and mapping and ablation technologies improved significantly during the last decade. However, data on long-term follow-up after AT ablation do not exist.
Aim: Therefore, we aimed to report long-term outcome after AT ablation.
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, all patients with a follow-up of at least 3 years after AT ablation were included.
Results: A total of 201 patients (mean age 59.4±16.3 years, 57.1% male, first AT ablation in 65.7%) with an arrhythmia history of 1.0±2.7 years underwent AT ablation. During a follow-up of 6.3±3.4 years, 121 patients (59.9%) developed any arrhythmia recurrence 29.6±32.6 months after ablation (Figure). Arrhythmia recurrences were AT in 70.4% and atrial fibrillation in 29.6%. Repeat ablation was performed in 78 (38.8%) patients after 36.6±36.2 months involving AT ablation in 61 (78.2%) patients, with 35 (44.9%) undergoing >1 repeat ablation (range 1–6 procedures). During repeat ablation, the index AT recurred in 6 patients (2.9%), including one perimitral macroreentrant AT, one microreentrant AT at the mitral annulus, one inferoseptal and inferolateral right-sided focal AT, one peritricuspid macroreentrant AT and one focal AT at the tricuspid annulus. Arrhythmia freedom after 1.6±1.0 procedures was 68.7%. A total of 189 (94.0%) patients were free from any arrhythmia recurrence, when including optimal usual care.
Conclusion: AT ablation results in arrhythmia-freedom in 40% of patients at 6 years after a single procedure. Repeat AT ablation is necessary in about one third of patients and improves long-term freedom from any arrhythmia recurrence. Recurrences of the index AT are rare and occur mainly at challenging anatomical localizations.
 

Figure: Long-term outcome after catheter ablation for atrial tachycardia. 
Freedom from arrhythmia recurrence after a single procedure and after multiple procedures is illustrated.
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