Scholarlink

Background <p>Pre-excitation syndromes such as Wolff–Parkinson–White increase risks of tachyarrhythmias and sudden cardiac death. While symptomatic patients undergo ablation, optimal management of asymptomatic individuals remains debated. This study aims to evaluate long-term outcomes of catheter ablation versus conservative management in asymptomatic patients utilizing real-world data.</p> Methods <p>In this observational cohort study using the U.S. Collaborative Network in TriNetX, patients ≥ 12 to 50 years with asymptomatic pre-excitation between September 1, 2010 and October 1, 2024 were identified. After 1:1 propensity score matching, 5,852 patients were included. The primary endpoint was all-cause mortality. Secondary endpoints included hospitalization, syncope, new onset of heart failure (HF), ventricular tachycardia/fibrillation (VT/VF), atrial fibrillation (AF) and antiarrhythmic drug (AAD) use up to 10 years of follow-up. Outcomes were compared between patients undergoing ablation versus those receiving medical therapy (GDMT).</p> Results <p>Over a mean follow-up of 1133 ± 1166 days, ablation was associated with reduced risks of the all-cause mortality (hazard ratio (HR) 0.25, 95%CI:0.13–0.48, <i>p</i> &lt; 0.001), HF onset (HR 0.48, 95%CI:0.26–0.85, <i>p</i> = 0.011) and hospitalization rates (HR 0.47, 95%CI:0.37–0.60, <i>p</i> &lt; 0.001). No significant differences were observed for new onset of VT/VF (HR 0.85, 95%CI:0.51–1.43, <i>p</i> = 0.534), AF (HR 1.61, 95%CI:1.00-2.62, <i>p</i> = 0.051) and syncope (HR 1.50, 95%CI:0.78–2.91, <i>p</i> = 0.224).</p> Conclusion <p>In asymptomatic patients with pre-excitation, catheter ablation was associated with a reduced mortality, fewer hospitalizations, and HF onset. These findings support considering ablation as a proactive strategy in selected asymptomatic individuals.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of catheter ablation in asymptomatic patients with pre-excitation syndrome - real world evidence

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月28日

查看全文
  • Maximilian Moersdorf,
  • Christian Massad,
  • Mohammad Montaser Atasi,
  • Yara Menassa,
  • Han Feng,
  • Michel Abou-Khalil,
  • Alex El Darzi,
  • Carlo El Khoury,
  • Qussay Marashly,
  • Rodolfo Montiel,
  • Philipp Sommer,
  • Amitabh C. Pandey,
  • Christian Sohns,
  • Nassir Marrouche

摘要

Background

Pre-excitation syndromes such as Wolff–Parkinson–White increase risks of tachyarrhythmias and sudden cardiac death. While symptomatic patients undergo ablation, optimal management of asymptomatic individuals remains debated. This study aims to evaluate long-term outcomes of catheter ablation versus conservative management in asymptomatic patients utilizing real-world data.

Methods

In this observational cohort study using the U.S. Collaborative Network in TriNetX, patients ≥ 12 to 50 years with asymptomatic pre-excitation between September 1, 2010 and October 1, 2024 were identified. After 1:1 propensity score matching, 5,852 patients were included. The primary endpoint was all-cause mortality. Secondary endpoints included hospitalization, syncope, new onset of heart failure (HF), ventricular tachycardia/fibrillation (VT/VF), atrial fibrillation (AF) and antiarrhythmic drug (AAD) use up to 10 years of follow-up. Outcomes were compared between patients undergoing ablation versus those receiving medical therapy (GDMT).

Results

Over a mean follow-up of 1133 ± 1166 days, ablation was associated with reduced risks of the all-cause mortality (hazard ratio (HR) 0.25, 95%CI:0.13–0.48, p < 0.001), HF onset (HR 0.48, 95%CI:0.26–0.85, p = 0.011) and hospitalization rates (HR 0.47, 95%CI:0.37–0.60, p < 0.001). No significant differences were observed for new onset of VT/VF (HR 0.85, 95%CI:0.51–1.43, p = 0.534), AF (HR 1.61, 95%CI:1.00-2.62, p = 0.051) and syncope (HR 1.50, 95%CI:0.78–2.91, p = 0.224).

Conclusion

In asymptomatic patients with pre-excitation, catheter ablation was associated with a reduced mortality, fewer hospitalizations, and HF onset. These findings support considering ablation as a proactive strategy in selected asymptomatic individuals.

Graphical Abstract