Military medicine · 2026
Atrioventricular Nodal Reentrant Tachycardia in Active Duty U. S. Military Service Members: Safety, Efficacy, and Retention After Catheter Ablation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Dean John-Henry L, Luckasen Mary C, Wurtz Paul J, Soderstrom Matthew A, Keithler Andrea N, Bush Kelvin N V
Аннотация
INTRODUCTION: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common supraventricular tachycardia. Its management of United States Active-Duty Service Members (ADSM) carries unique career implications and may affect military retention. Data on procedural and retention outcomes in this high-performing population remain limited.
MATERIALS AND METHODS: We conducted a single-center, retrospective observational study of ADSMs diagnosed with AVNRT confirmed by invasive electrophysiology study (EPS) between 2015 and 2022. Demographics, procedural details, recurrence, complications, and military occupational outcomes were collected. The primary endpoints were acute ablation success, long-term recurrence, and subsequent rates of military retention.
RESULTS: Forty-one ADSMs (mean age 32.7 ± 11.2 years; 68% male) underwent EP study and slow pathway modification for AVNRT. Acute procedural success was achieved in all cases (100%; 95% CI, 91.4-100%) with no procedural complications. Over a mean follow-up of 73 months (range 13-115 months), recurrence of AVNRT occurred in 3 patients (7.3%; 95% CI, 1.5-19.9%), with 2 successfully treated with repeat ablation. Most ADSMs (78%; 95% CI, 62.4-89.4%) returned to unrestricted duty; 9 (22%; 95% CI, 10.6-37.6%) required temporary restrictions, 6 (14.6%; 95% CI, 5.6-29.2%) underwent occupational reassignment, and none were separated due to AVNRT recurrence. No deaths, heart failure hospitalizations, or malignant arrhythmias were observed.
CONCLUSIONS: Slow pathway modification for AVNRT in ADSMs is both safe and highly effective, enabling the majority to resume unrestricted military service. Although recurrence was observed in a minority, repeat ablation remained effective, and no separations in this cohort were attributed to recurrent AVNRT. These findings are consistent with guideline recommendations supporting catheter ablation as a definitive therapy for symptomatic AVNRT in tactical and aviation personnel across military branches, promoting both successful treatment of underlying AVNRT and return to full military duty.
MATERIALS AND METHODS: We conducted a single-center, retrospective observational study of ADSMs diagnosed with AVNRT confirmed by invasive electrophysiology study (EPS) between 2015 and 2022. Demographics, procedural details, recurrence, complications, and military occupational outcomes were collected. The primary endpoints were acute ablation success, long-term recurrence, and subsequent rates of military retention.
RESULTS: Forty-one ADSMs (mean age 32.7 ± 11.2 years; 68% male) underwent EP study and slow pathway modification for AVNRT. Acute procedural success was achieved in all cases (100%; 95% CI, 91.4-100%) with no procedural complications. Over a mean follow-up of 73 months (range 13-115 months), recurrence of AVNRT occurred in 3 patients (7.3%; 95% CI, 1.5-19.9%), with 2 successfully treated with repeat ablation. Most ADSMs (78%; 95% CI, 62.4-89.4%) returned to unrestricted duty; 9 (22%; 95% CI, 10.6-37.6%) required temporary restrictions, 6 (14.6%; 95% CI, 5.6-29.2%) underwent occupational reassignment, and none were separated due to AVNRT recurrence. No deaths, heart failure hospitalizations, or malignant arrhythmias were observed.
CONCLUSIONS: Slow pathway modification for AVNRT in ADSMs is both safe and highly effective, enabling the majority to resume unrestricted military service. Although recurrence was observed in a minority, repeat ablation remained effective, and no separations in this cohort were attributed to recurrent AVNRT. These findings are consistent with guideline recommendations supporting catheter ablation as a definitive therapy for symptomatic AVNRT in tactical and aviation personnel across military branches, promoting both successful treatment of underlying AVNRT and return to full military duty.