Prevalence of stroke among patients with paroxysmal supraventricular tachycardia.

BACKGROUND: To assess the prevalence of unexplained stroke in patients with paroxysmal supraventricular tachycardia (SVT). The risk of atrial fibrillation (AF) is well known and risk of stroke can be expected.
METHODS: A total of 1,362 patients were referred for SVT, confirmed by electrophysiological study. Patients with anterograde conduction over accessory pathway (AP) were excluded. Clinical and electrophysiological data were collected.
RESULTS: Stroke was noted in 38 patients with a prevalence of 2.8%. Patients with stroke were older (62 ± 12 years vs 49 ± 19 years; P < 0.0001). Heart disease (34% vs 10%; P < 0.0001) and AF history (10.5% vs 2%; P < 0.001) were more frequent. Male gender was as frequent in patients with and without stroke (45% vs 39.5%; NS). SVT mechanism was similar: AV reentrant tachycardia over concealed AP was 10.5% in patients with stroke and 18.5% in other patients (NS). Atrioventricular node reentrant tachycardias represent other mechanisms. After 2.6 ± 2.5 years, SVT ablation was performed less frequently in patients with stroke (37% vs 63%; P < 0.001); three patients without previous stroke presented a stroke. AF and cardiovascular death were more frequent in patients with stroke (21% vs 4.6%; P < 0.000), (8% vs 2%; P < 0.008). Note that 7.6% of patients treated with ablation and 6% of patients without ablation had an event (stroke, AF, death; NS).
CONCLUSIONS: Unexplained stroke was rare in patients with SVT, noted in 2.8% of this population. Old age and AF history were the predictors of stroke. These patients had a risk of adverse events as AF or death. SVT ablation did not seem to reduce the risk of new stroke, AF or death. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.