Background: Catheter ablation for paroxysmal supraventricular tachycardia (PSVT) is potentially curative but little is known about the frequency or timing of repeat ablations.
Purpose: To characterise repeat ablations in patients <65 years with PSVT.
Methods: Retrospective study using demographic, enrolment, and claims data from the IBM MarketScan® research database to identify patients <65 years with an initial catheter ablation for PSVT (ICD-9: 427.0; ICD-10: I47.1) between January 1, 2009 and December 31, 2015. Patients were required to be observable for 1 year before and after index ablation; a subset of patients was followed for up to 7 years post index. Primary outcome was repeat ablation within 1 year; Secondary outcome was repeat ablation in all follow-up. Logistic regression was used to assess odds of re-ablation.
Results: 20,649 patients meet the study criteria; mean age was 44 years (SD: 15.6), 59.1% were female sex. 1,520 (7.4%) had a second ablation within 12 months of the first, and the majority were within 6 months (n=1,067; 70.2%). Re-ablation rates increased to 12.4% in patients observable 2 years post-index and to 14.9% by 7 years post-index ablation (Figure 1). Male sex was significantly associated with higher re-ablation rates (8.6% versus 6.5% p<0.0001); age was not significantly associated.
Conclusion: Approximately, 1 in 8 patients that has an ablation for PSVT goes on to have a second ablation for PSVT within 2 years. More data is needed on predictors of patients that have >1 ablation for PSVT, as well as the optimal management strategy for these patients.