Arrhythmias & electrophysiologyCohort study

Incidence of Worsening Aortic Regurgitation After Mapping and Ablation in the Aortic Cusps

JACC Clin ElectrophysiolPublished

  • multicenter cohort
  • retrospective
  • 4 high-volume centers (2015-2024)

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

Main finding

As reported in the abstract

Clinically significant AR (≥2-grade worsening or new moderate AR)

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

Incidence of Worsening Aortic Regurgitation After Mapping and Ablation in the Aortic Cusps. JACC Clin Electrophysiol. Published 23 April 2026. doi:10.1016/j.jacep.2026.03.039

Summarised from the published abstract; every number is checked against it