Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Short Communication

Volume 14, Number 5, October 2023, pages 403-408

Outcomes After Supraventricular Tachycardia Ablation in Patients With Group 1 Pulmonary Hypertension

**Table 1.** Baseline Patient Characteristics Stratified by Presence of Any Recurrence of an Initially Ablated Arrhythmia During Maximum Available Follow-Up Time
	Overall (n = 38)	No recurrence (n = 28)	Recurrence (n = 10)	P-value
Most recent values available within 1 year of index procedure are shown. Not all values were available for all included patients; values shown are calculated from available values. ^aNon-parenteral PH therapies included: selexipag, ambrisentan, bosentan, macitentan, riociguat, sildenafil, tadalafil, inhaled treprostinil. ^bParenteral PH therapies included: IV epoprostenol, IV/subcutaneous treprostinil. BMI: body mass index; 6MWT: six-minute walk test; LV: left ventricle; RV: right ventricle; TAPSE: tricuspid annular systolic plane excursion; RA: right atrium; PA: pulmonary artery; PVR: pulmonary vascular resistance; IQR: interquartile range; SD: standard deviation.
Male sex (%)	17 (44.7)	12 (42.9)	5 (50.0)	0.73
Mean age (years) (SD)	53.7 (13.7)	52.4 (13.8)	57.6 (13.5)	0.35
Mean BMI (SD)	28.8 (7.2)	28.0 (7.2)	31.1 (7.2)	0.23
Medications (%)
Beta-blocker	11 (28.9)	9 (32.1)	2 (20.0)	0.69
Calcium channel blocker	5 (13.2)	3 (10.7)	2 (20.0)	0.59
Digoxin	9 (23.7)	8 (28.6)	1 (10.0)	0.40
Flecainide	2 (5.3)	1 (3.6)	1 (10.0)	0.46
Sotalol	1 (2.6)	0 (0.0)	1 (10.0)	0.26
Dofetilide	1 (2.6)	0 (0.0)	1 (10.0)	0.26
Amiodarone	2 (5.3)	0 (0.0)	2 (20.0)	0.06
One non-parenteral PH therapy^a	12 (31.6)	7 (25.0)	5 (50.0)	0.23
Two non-parenteral PH therapies	3 (7.9)	3 (10.7)	0 (0.0)	0.55
Three or more non-parenteral PH therapies	9 (23.7)	8 (28.6)	1 (10.0)	0.40
Parenteral^b +/- non-parenteral PH therapy	11 (28.9)	8 (28.6)	3 (30.0)	1.00
Median 6MWT distance (m) (SD)	302.3 (144.3)	294.8 (146.0)	323.9 (148.6)	0.66
WHO functional class (%)				0.38
II	7 (25.9)	7 (31.8)	0 (0.0)
III	18 (66.7)	13 (59.1)	5 (100.0)
IV	2 (7.4)	2 (9.1)	0 (0.0)
Comorbidities (%)
Left-heart disease	7 (18.4)	4 (14.3)	3 (30.0)	0.35
Lung disease	5 (13.2)	5 (17.9)	0 (0.0)	0.30
Median time from PH diagnosis (days) (IQR)	2,420 (593 - 3,647)	2,289 (313 - 3,909)	2,550 (1,014 - 2,769)	0.90
Echocardiography
Mean LV ejection fraction (%) (SD)	58.9 (12.5)	60.0 (13.1)	55.8 (10.4)	0.08
RV systolic function, qualitative (%)				0.53
Normal	8 (24.2)	5 (20.8)	3 (33.3)
Mild depression	9 (27.3)	6 (25.0)	3 (33.3)
Moderate depression	11 (33.3)	8 (33.3)	3 (33.3)
Severe depression	5 (15.2)	5 (20.8)	0 (0.0)
Mean RV systolic pressure (mm Hg) (SD)	59.8 (21.7)	61.6 (22.0)	54.0 (20.8)	0.53
Mean RV systolic velocity (cm/s) (SD)	11.0 (3.7)	11.0 (0.4)	11.1 (0.5)	0.67
RV TAPSE (cm) (SD)	1.8 (0.5)	1.8 (0.4)	1.7 (0.5)	0.78
RV tricuspid regurgitation, qualitative (%)				0.51
Trace	6 (17.6)	6 (23.1)	0 (0.0)
Mild	11 (32.4)	7 (26.9)	4 (50.0)
Moderate	9 (26.5)	7 (26.9)	2 (25.0)
Severe	8 (23.5)	6 (23.1)	2 (25.0)
Right heart catheterization
Mean RA pressure (mm Hg) (SD)	11.0 (8.5)	10.5 (7.9)	13.0 (10.8)	0.76
Mean PA pressure (mm Hg) (SD)	46.1 (10.4)	43.9 (8.8)	53.5 (12.9)	0.13
Mean PVR (Wood units) (SD)	6.9 (2.7)	7.2 (2.8)	6.0 (2.2)	0.45
Mean pulmonary capillary wedge pressure (mm Hg) (SD)	10.4 (7.6)	9.1 (7.2)	15.4 (7.7)	0.05
Mean cardiac index (SD)	2.9 (0.8)	2.9 (0.9)	3.0 (0.5)	0.63
Cardiac magnetic resonance imaging
RA volume, qualitative (%)				1.0
Normal	3 (18.8)	2 (16.7)	1 (25.0)
Mild dilation	3 (18.8)	2 (16.7)	1 (25.0)
Moderate/severe dilation	10 (62.5)	8 (66.7)	2 (50.0)
RV systolic function, qualitative (%)				1.0
Normal	5 (33.3)	3 (27.3)	2 (50.0)
Mild depression	2 (13.3)	2 (18.2)	0 (0.0)
Moderate depression	3 (20.0)	2 (18.2)	1 (25.0)
Severe depression	5 (33.3)	4 (36.4)	1 (25.0)
Mean RV ejection fraction (%) (SD)	39.1 (14.2)	39.2 (15.8)	38.8 (9.4)	0.86

Table 1. Baseline Patient Characteristics Stratified by Presence of Any Recurrence of an Initially Ablated Arrhythmia During Maximum Available Follow-Up Time

Overall (n = 38)

No recurrence (n = 28)

Recurrence (n = 10)

P-value

Most recent values available within 1 year of index procedure are shown. Not all values were available for all included patients; values shown are calculated from available values. ^aNon-parenteral PH therapies included: selexipag, ambrisentan, bosentan, macitentan, riociguat, sildenafil, tadalafil, inhaled treprostinil. ^bParenteral PH therapies included: IV epoprostenol, IV/subcutaneous treprostinil. BMI: body mass index; 6MWT: six-minute walk test; LV: left ventricle; RV: right ventricle; TAPSE: tricuspid annular systolic plane excursion; RA: right atrium; PA: pulmonary artery; PVR: pulmonary vascular resistance; IQR: interquartile range; SD: standard deviation.

Male sex (%)

17 (44.7)

12 (42.9)

5 (50.0)

0.73

Mean age (years) (SD)

53.7 (13.7)

52.4 (13.8)

57.6 (13.5)

0.35

Mean BMI (SD)

28.8 (7.2)

28.0 (7.2)

31.1 (7.2)

0.23

Medications (%)

Beta-blocker

11 (28.9)

9 (32.1)

2 (20.0)

0.69

Calcium channel blocker

5 (13.2)

3 (10.7)

2 (20.0)

0.59

Digoxin

9 (23.7)

8 (28.6)

1 (10.0)

0.40

Flecainide

2 (5.3)

1 (3.6)

1 (10.0)

0.46

Sotalol

1 (2.6)

0 (0.0)

1 (10.0)

0.26

Dofetilide

1 (2.6)

0 (0.0)

1 (10.0)

0.26

Amiodarone

2 (5.3)

0 (0.0)

2 (20.0)

0.06

One non-parenteral PH therapy^a

12 (31.6)

7 (25.0)

5 (50.0)

0.23

Two non-parenteral PH therapies

3 (7.9)

3 (10.7)

0 (0.0)

0.55

Three or more non-parenteral PH therapies

9 (23.7)

8 (28.6)

1 (10.0)

0.40

Parenteral^b +/- non-parenteral PH therapy

11 (28.9)

8 (28.6)

3 (30.0)

1.00

Median 6MWT distance (m) (SD)

302.3 (144.3)

294.8 (146.0)

323.9 (148.6)

0.66

WHO functional class (%)

0.38

7 (25.9)

7 (31.8)

0 (0.0)

III

18 (66.7)

13 (59.1)

5 (100.0)

2 (7.4)

2 (9.1)

0 (0.0)

Comorbidities (%)

Left-heart disease

7 (18.4)

4 (14.3)

3 (30.0)

0.35

Lung disease

5 (13.2)

5 (17.9)

0 (0.0)

0.30

Median time from PH diagnosis (days) (IQR)

2,420 (593 - 3,647)

2,289 (313 - 3,909)

2,550 (1,014 - 2,769)

0.90

Echocardiography

Mean LV ejection fraction (%) (SD)

58.9 (12.5)

60.0 (13.1)

55.8 (10.4)

0.08

RV systolic function, qualitative (%)

0.53

Normal

8 (24.2)

5 (20.8)

3 (33.3)

Mild depression

9 (27.3)

6 (25.0)

3 (33.3)

Moderate depression

11 (33.3)

8 (33.3)

3 (33.3)

Severe depression

5 (15.2)

5 (20.8)

0 (0.0)

Mean RV systolic pressure (mm Hg) (SD)

59.8 (21.7)

61.6 (22.0)

54.0 (20.8)

0.53

Mean RV systolic velocity (cm/s) (SD)

11.0 (3.7)

11.0 (0.4)

11.1 (0.5)

0.67

RV TAPSE (cm) (SD)

1.8 (0.5)

1.8 (0.4)

1.7 (0.5)

0.78

RV tricuspid regurgitation, qualitative (%)

0.51

Trace

6 (17.6)

6 (23.1)

0 (0.0)

Mild

11 (32.4)

7 (26.9)

4 (50.0)

Moderate

9 (26.5)

7 (26.9)

2 (25.0)

Severe

8 (23.5)

6 (23.1)

2 (25.0)

Right heart catheterization

Mean RA pressure (mm Hg) (SD)

11.0 (8.5)

10.5 (7.9)

13.0 (10.8)

0.76

Mean PA pressure (mm Hg) (SD)

46.1 (10.4)

43.9 (8.8)

53.5 (12.9)

0.13

Mean PVR (Wood units) (SD)

6.9 (2.7)

7.2 (2.8)

6.0 (2.2)

0.45

Mean pulmonary capillary wedge pressure (mm Hg) (SD)

10.4 (7.6)

9.1 (7.2)

15.4 (7.7)

0.05

Mean cardiac index (SD)

2.9 (0.8)

2.9 (0.9)

3.0 (0.5)

0.63

Cardiac magnetic resonance imaging

RA volume, qualitative (%)

1.0

Normal

3 (18.8)

2 (16.7)

1 (25.0)

Mild dilation

3 (18.8)

2 (16.7)

1 (25.0)

Moderate/severe dilation

10 (62.5)

8 (66.7)

2 (50.0)

RV systolic function, qualitative (%)

1.0

Normal

5 (33.3)

3 (27.3)

2 (50.0)

Mild depression

2 (13.3)

2 (18.2)

0 (0.0)

Moderate depression

3 (20.0)

2 (18.2)

1 (25.0)

Severe depression

5 (33.3)

4 (36.4)

1 (25.0)

Mean RV ejection fraction (%) (SD)

39.1 (14.2)

39.2 (15.8)

38.8 (9.4)

0.86

**Table 2.** Initial Success Rates and Outcomes of Attempted Ablations Stratified by Arrhythmia Type
Arrhythmia	Total attempted	Initially successful ablations	Recurrence rate at 3 months (n available)	Recurrence rate at 1 year (n available)	Initial success rates previously observed in general population	Long-term (≥ 1 year) recurrence rates previously observed in general population
Sample sizes shown indicate number of patients available for follow-up at each time point. Initially unsuccessful ablations were not included in recurrence calculations. For comparison, initial success rates and long-term (i.e., average follow-up of 12 months or greater) recurrence rates of AF, typical and atypical AFL, AT, and AVNRT from prior studies in the general population [11, 12, 15-23] are reproduced in this table. AF: atrial fibrillation; AFL: atrial flutter; AT: atrial tachycardia; AVNRT: atrioventricular nodal reentrant tachycardia; CTI: cavotricuspid isthmus.
AF	5	4 (80%)	100% (4)	100% (4)	93.1-96.4%	29.8-45.6%
CTI-dependent typical AFL	29	26 (89.7%)	4.2% (24)	25% (20)	96.0-98.3%	10.9-30%
Atypical AFL	7	4 (57.1%)	25% (4)	50% (2)	79-90%	23-27%
AT	15	9 (60%)	22.2% (9)	28.6% (7)	84.3-93.6%	22-32.3%
AVNRT	4	3 (75%)	0% (3)	0% (2)	98.9-99.8%	3.9-4.5%

Table 2. Initial Success Rates and Outcomes of Attempted Ablations Stratified by Arrhythmia Type

Arrhythmia

Total attempted

Initially successful ablations

Recurrence rate at 3 months (n available)

Recurrence rate at 1 year (n available)

Initial success rates previously observed in general population

Long-term (≥ 1 year) recurrence rates previously observed in general population

Sample sizes shown indicate number of patients available for follow-up at each time point. Initially unsuccessful ablations were not included in recurrence calculations. For comparison, initial success rates and long-term (i.e., average follow-up of 12 months or greater) recurrence rates of AF, typical and atypical AFL, AT, and AVNRT from prior studies in the general population [11, 12, 15-23] are reproduced in this table. AF: atrial fibrillation; AFL: atrial flutter; AT: atrial tachycardia; AVNRT: atrioventricular nodal reentrant tachycardia; CTI: cavotricuspid isthmus.

4 (80%)

100% (4)

93.1-96.4%

29.8-45.6%

CTI-dependent typical AFL

26 (89.7%)

4.2% (24)

25% (20)

96.0-98.3%

10.9-30%

Atypical AFL

4 (57.1%)

25% (4)

50% (2)

79-90%

23-27%

9 (60%)

22.2% (9)

28.6% (7)

84.3-93.6%

22-32.3%

AVNRT

3 (75%)

0% (3)

0% (2)

98.9-99.8%

3.9-4.5%