Clinical Electrophysiology -> SVT/AVNRT/WPW/AT: -> Epidemiology of Cardiac Arrhythmias/ Epidemiology D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-234 - Timing Of Recurrence Post-ablation For Accessory Pathways In Wolff Parkinson White Syndrome (ID 508)


Background: Accessory pathway (AP) recurrence is seen in 1.2-12% of patients with Wolff Parkinson White (WPW) syndrome after AP ablation. However, there is limited data available on long-term outcomes to guide follow-up practice.
Objective: The objective of this study is to determine the timing of recurrence following successful ablation of APs in WPW.
Methods: We queried our EP Lab Database (Version 1.4.36) for patients who underwent successful AP ablation for WPW at the Cleveland Clinic with at least one follow up encounter in our institution from January 1, 2000 to August 1, 2019. Recurrence was defined as demonstration of pre-excitation on ECG and/or confirmation of the presence of the previously ablated AP on a repeat electrophysiological study.
Results: The database identified 233 patients who had at least one follow-up in our institution and 166 patients met inclusion criteria. Median follow up was 16.1 months (IQR 2.7 - 40.2). Recurrence occurred in 10 patients (6.0%). Median time to recurrence was 2.41 months (IQR 0.6 - 10.6). Of those patients with recurrence, 7 (70%) recurred within 12 months, and only 3 (30%) patients had recurrence more than 12 months after ablation (see Figure 1). Routine follow up captured recurrences in 7 patients (70% of all with recurrence). The other 3 patients with recurrence (30%) were captured after palpitations prompted follow-up.
Conclusion: Late recurrence was not common in our cohort with only 3 patients (1.8% of our cohort) recurring greater than 12 months after ablation. However, 70% of all patients with recurrence were captured during asymptomatic routine follow up suggesting the need for obligate follow-up post-ablation.