Arrhythmias & electrophysiology
Incidence of Worsening Aortic Regurgitation After Mapping and Ablation in the Aortic Cusps
Authors' conclusion
Significant AR occurred in approximately 1% after AC mapping/ablation. New mild AR developed in 12.5% and improved in more than one-half during follow-up. No valve interventions were required, supporting the safety of cusp and commissural ablation at experienced centers.
Study context
- Population
- Patients who underwent AC/commissural mapping and/or ablation for ventricular arrhythmia and had paired preprocedural and postprocedural transthoracic echocardiograms (TTEs)208 (218 procedures) had complete paired TTEs
- Participants
- 290 patients
- Outcome
- Clinically significant AR (≥2-grade worsening or new moderate AR)
Methodological detailsretrospective, 4 high-volume centers (2015-2024)
- Retrospective
- 4 high-volume centers (2015-2024)
Main finding
As reported in the abstract
Procedures with clinically significant aortic regurgitation (AR)
2 procedures
0.9%
Observational data: associations, not effects.
Further findings
New mild AR (1-grade increase from none to mild)
- Procedures with new mild AR
- 26 procedures (11.9%)
AR course among those with additional follow-up imaging · median 320 days after first postprocedural TTE
- Patients with additional follow-up imaging
- 14
- AR resolved, of the 14
- 8 (57%)
- AR remained mild, of the 14
- 6 (43%)
Valve intervention
- No patient required valve intervention
Baseline AR and procedural characteristics
- Baseline AR absent
- 81%
- Baseline AR mild
- 18%
- Retrograde aortic access
- 94%
- Radiofrequency ablation within the cusps
- 77%
Original publication
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