Long-term outcome after catheter ablation for atrial tachycardia: insights from the SATELLITE Study group

Abstract 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. Purpose 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.Long-term outcome after AT ablation