Radiofrequency ablation of accessory pathways in patients with the Wolff-Parkinson-White syndrome: Long-term risk of mortality and coronary events

Wanwarang Wongcharoen, Yenn Jiang Lin*, Fa Po Chung, Yun Yu Chen, Tze Fan Chao, Pei Chun Chen, Kuo Liong Chien, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

4 Scopus citations

Abstract

Aims The long-term outcomes of radiofrequency catheter ablation (RFCA) in patients with Wolff-Parkinson-White syndrome (WPW) remain unclear. We investigated the impact of RFCA on the long-term risk of coronary events and mortality in WPW patients. Methods and results We conducted a prospective cohort study utilizing the Taiwan National Health Insurance Research Database. Between 2000 and 2003, WPW patients with no prior coronary artery disease (CAD) history, aged over 18 years, who underwent RFCA were identified. WPW patients without RFCA were matched with propensity-score 1:4 matching for confounding coronary risk factors. The study outcomes were total mortality and coronary events. A total of 1524 matched non-ablated WPW patients (Group 1) and 381 ablated WPW patients (Group 2) were included. After a mean follow-up of 9.6 ± 2.9 and 10.3 ± 1.9 years, respectively, ablation group demonstrated a lower incidence of mortality compared with non-ablation group (17 vs. 26/1000 person-years, P < 0.001; adjusted HR: 0.57, 95% CI: 0.44-0.7). However, ablation group had a higher incidence of coronary events compared with non-ablation group (47 vs. 82/1000 person-years, P < 0.001; adjusted HR: 1.69, 95% CI: 1.4-2.04). Conclusion The ablation-treated WPW patients had lower risk of total mortality but higher risk of coronary events than non-ablated WPW patients during the long-term follow-up. Coronary artery injury produced by RFCA may account for the increased risk of coronary events. Therefore, the ablation strategies to avoid coronary artery injury should be implemented.

Original languageEnglish
Pages (from-to)1035-1042
Number of pages8
JournalEuropace
Volume20
Issue number6
DOIs
StatePublished - 01 06 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Published on behalf of the European Society of Cardiology. All rights reserved.

Keywords

  • Ablation
  • Accessory pathway
  • Coronary artery disease
  • Mortality
  • Outcome
  • Wolff-Parkinson-White syndrome

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