Spanish catheter ablation registry. 21st official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021).

INTRODUCTION AND OBJECTIVES: The results of the 2021 Spanish catheter ablation registry are presented. METHODS: Data collection was carried out retrospectively by filling in and sending a specific form by the participating centers. RESULTS: Data from 93 centers (65 public, 28 private) were analyzed. A total of 17941 ablation procedures were reported with a mean of 193 ± 133 cases per centre. Recovery of activity from SARS-CoV-2 pandemic lockdown has led to a notable increase in the number of procedures (+2772 procedures, +18%) despite a small decrease in participating centers (4 centers less than in 2020). Atrial fibrillation ablation continues to be the leading procedure, with 5848 procedures (32,6%). Together with ablation of the cavotricuspid isthmus (3766; 21%) and atrioventricular nodal reentrant tachycardia (3132; 17,5%) they constitute the 3 most frequently approached substrates. The total success rate reported (94%) is similar to previous years with a similar rate of complications (2%) and mortality (0.07). A total of 401 procedures were performed in pediatric patients (3,8%). CONCLUSIONS: The Spanish catheter ablation registry systematically and continuously collects the national activity, which has recovered significantly from the SARS-CoV-2 pandemic impact in 2020. Success rate for 2021 remains high, with a low complication rate.

Registro español de ablación con catéter. XXI Informe oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2021) Spanish catheter ablation registry. 21st official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021)

Introducción y objetivos Se describen los resultados del Registro español de ablación con catéter correspondientes al año 2021, marcado por la recuperación de la actividad tras la pandemia de SARS-CoV-2. Métodos La recogida de datos fue restrospectiva mediante la cumplimentación y el envío de un formulario específico por los centros participantes. Resultados Se analizaron los datos de 93 centros (65 públicos, 28 privados). Se comunicaron 17.941 procedimientos de ablación con una media de 193 ± 133 y mediana de 171. La recuperación de la actividad tras el cierre por la pandemia de SARS-CoV-2 ha supuesto un marcado aumento de procedimientos (+2.772 casos, +18%) a pesar de un ligero descenso en el número de centros participantes (4 menos que en 2020). La ablación de la fibrilación auricular sigue siendo el procedimiento más frecuente, a distancia del resto de sustratos (5.848;32,6%). Junto con la ablación del istmo cavotricuspídeo (3.766;21%) y la taquicardia por reentrada intranodular (3.132;17,5%), constituye los 3 sustratos abordados con más frecuencia. Las tasas comunicadas de éxito (94%), complicaciones (2%) y mortalidad (0,07%) son similares a las de años previos. Se realizaron 401 procedimientos en pacientes pediátricos (el 3,8% del total). Conclusiones El Registro español de ablación con catéter recoge de manera sistemática e ininterrumpida la actividad nacional, y este año se ha observado una marcada recuperación de la actividad a pesar del persistente efecto de la pandemia de SARS-CoV-2. La tasa de éxito sigue manteniéndose elevada, con una baja tasa de complicaciones.

Inappropriate sinus tachycardia in post-COVID-19 syndrome.

Inappropriate sinus tachycardia (IST) is a common observation in patients with post-COVID-19 syndrome (PCS) but has not yet been fully described to date. To investigate the prevalence and the mechanisms underlying IST in a prospective population of PCS patients. Consecutive patients admitted to the PCS Unit between June and December 2020 with a resting sinus rhythm rate ≥ 100 bpm were prospectively enrolled in this study and further examined by an orthostatic test, 2D echocardiography, 24-h ECG monitoring (heart rate variability was a surrogate for cardiac autonomic activity), quality-of-life and exercise capacity testing, and blood sampling. To assess cardiac autonomic function, a 2:1:1 comparative sub-analysis was conducted against both fully recovered patients with previous SARS-CoV-2 infection and individuals without prior SARS-CoV-2 infection. Among 200 PCS patients, 40 (20%) fulfilled the diagnostic criteria for IST (average age of 40.1 ± 10 years, 85% women, 83% mild COVID-19). No underlying structural heart disease, pro-inflammatory state, myocyte injury, or hypoxia were identified. IST was accompanied by a decrease in most heart rate variability parameters, especially those related to cardiovagal tone: pNN50 (cases 3.2 ± 3 vs. recovered 10.5 ± 8 vs. non-infected 17.3 ± 10; p < 0.001) and HF band (246 ± 179 vs. 463 ± 295 vs. 1048 ± 570, respectively; p < 0.001). IST is prevalent condition among PCS patients. Cardiac autonomic nervous system imbalance with decreased parasympathetic activity may explain this phenomenon.