Long-term effect of catheter ablation on tachycardia-bradycardia syndrome: evidenced by 10 years follow up

Background: Catheter ablation has been used for the treatment of tachycardia-bradycardia syndrome (TBS). However, data on its long-term effect of rhythm control and stroke are limited. Method and results: Patients with TBS admitted in the First Affiliated Hospital of Dalian Medical University from 2002 to 2013 were reviewed in the present study. A total of 150 patients were enrolled. Seventy-nine patients underwent catheter ablation (CA group) and 71 patients chose implantation of pacemaker (PM group). The two groups were followed up for 123.01 ± 29.68 and 120.67 ± 31.05 months respectively. The CA group underwent 1.2 ± 0.5 procedure. Of the CA group, 70.9% patients exhibited sinus rhythm without long pauses or the need of anti-arrhythmia drugs (AADs). In contrast, no patient in the PM group was free of atrial fibrillation (AF). A higher proportion in the PM group progressed to persistent AF than in that in the CA group (9.9% vs. 1.3%, p <.05). The incidence of new-onset stroke in the PM group was significantly higher than that in the CA group (15.4% vs. 5.1%, p <.05). Conclusions: Even for long-term following up, catheter ablation is effective for preventing both the tachycardia and bradycardia components for the majority of patients with TBS without the need for further pacemaker implantation. Furthermore, ablation can reduce the stroke incidence of TBS through eliminating AF and reducing the progression to persistent AF.