Cogprints

Atrial fibrillation and its determinants after radiofrequency ablation of chronic common atrial flutter

Cade, Stéphane and Sedighian, Shahine and Bortone, Agustin and Gervasoni, Richard and Macia, Jean Christophe and Leclercq, Florence and Grolleau, Robert and Pasquié, Jean Luc (2005) Atrial fibrillation and its determinants after radiofrequency ablation of chronic common atrial flutter. [Journal (Paginated)]

Full text available as:

[img]HTML
41Kb
[img]
Preview
PDF
237Kb

Abstract

Aim. Atrial fibrillation (AFib) is a major clinical issue and its occurrence is the main problem after catheter ablation of atrial flutter. The long-term occurrence of AFib after common atrial flutter ablation is still matter of debate as it may influence the therapeutic approach. So, the aim of our study was to analyze the determinants and the time course of AFib after radiofrequency catheter ablation of chronic common atrial flutter. Methods and Results. 89 consecutive patients (67.5 ± 12.0 yrs) underwent RF ablation of chronic common atrial flutter. 38.2 % had previous history of paroxysmal AFib. 51% had no underlying structural heart disease. Over a mean follow-up of 38 ± 13 months, the occurrence rate of AFib progressively increased up to 32.9% at the end of follow-up. The median occurrence time for AFib was 8 months. AFib occurrence was significantly associated with previous AFib history (P=0.01) but not with the presence of underlying heart disease (P=n.s.). Of particular interest, in our study, AFib never occurred in patients without previous AFib history. Palpitations after chronic common atrial flutter ablation was mostly related to AFib. Conclusion. In conclusion, after chronic common atrial flutter ablation, AFib incidence progressively increased over the follow-up in all patients. Patients with prior AFib history appeared to be a very high risk group. In these patients, closer monitoring is mandatory and the persistent risk of AFib recurrences may justify prolonged anticoagulation policy.

Item Type:Journal (Paginated)
Keywords:atrial fibrillation; atrial flutter; follow-up; radiofrequency catheter ablation
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4593
Deposited By:Indian Pacing and Electrophysiology, Journal
Deposited On:12 Nov 2005
Last Modified:11 Mar 2011 08:56

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Natale A, Newby K, Pisano E et al. Prospective ramdomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol 2000;35 :1898-904

2. Anselme F, Saoudi N, Poty H et al. Radiofrequency catheter ablation of common atrial flutter : significance of palpitations and quality-of-life evaluation in patients with proven isthmus block. Circulation 1999;99 :534-40

3. Stewart S, Hart CL, Hole DJ et al. A population based study of the long-term risks associated with atrial fibrillation. Am J Med 2002; 113: 359-364

4. Movsowitz C, Callans DJ, Schartzman D et al. The results of atrial flutter ablation in patients with and without a history of atrial fibrillation. Am J Cardiol 1996; 78 : 93-96

5. Katritsis D, Iliodromitis E, Fragakis N et al. Ablation therapy of type I atrial flutter may eradicate paroxysmal atrial fibrillation. Am J Cardiol 1996; 78 : 345-347

6. Schmieder S, Ndrepepa G, Dong J et al. Acute and long-term results of radiofrequency ablation of common atrial flutter and the influence of right isthmus ablation on the occurrence of atrial fibrillation. Eur Heart J 2003; 24 : 956-962

7. Nabar A, Rodriguez L, Timmermans C et al. Effect of right atrial isthmus ablation on the occurrence of atrial fibrillation : observations in four patients groups having type I atrial flutter with or without associated atrial fibrillation. Circulation 1999;99 : 1441-5

8. Gilligan DM, Zakaib JS, Fuller I et al. Long-term outcome of patients after successful radiofrequency ablation for typical atrial flutter. Pacing Clin Electrophysiol 2003; 26 (Pt 1): 53-58

9. Hsieh MH, Tai CT, Chiang CE et al. Recurrent atrial flutter and atrial fibrillation after catheter ablation of the cavotricuspid isthmus : a very long-term follow-up of 333 patients. J Interv Card Electrophysiol 2002; 7 : 225-231

10. Sparks PB, Jayaprakash S, Vohra JK et al. Electrical remodelling of the atria associated with paroxysmal and chronic atrial flutter. Circulation 2000; 102 : 1807-1813

11. Fischer B, Jais P, Shah D et al. Radiofrequency catheter ablation of common atrial flutter in 200 patients. J Card Electrophysiol 1996 ;7 :1225-33

12. Cauchemez B, Haissaguerre M, Fischer B et al. Electrophysiological effects of catheter ablation of inferior vena cava-tricuspid annulus isthmus in common atrial flutter. Circulation 1996; 93 : 284-294

13. Kirkorian G, Moncada E, Chevalier P et al. Radiofrequency ablation of atrial flutter. Efficacy of an anatomically guided approach. Circulation 1994; 90 : 2804-2814

14. Cosio FG, Lopez-Gil M, Goicolea A et al. Radiofrequency ablation of the inferior vena cava-tricuspid valve isthmus in common atrial flutter. Am J Cardiol 1993; 71 : 705-709

15. Cosio F, Lopez-Gil M, Arribas F, Goicolea A et al. The ablation of atrial flutter. The long-term results after 8 years of experience. Rev Esp cardiol 1998;51 :832-9

16. O’Callaghan PA, Meara M, Kongsgaard E et al. Symptomatic improvement after radiofrequency catheter ablation for typical atrial flutter. Heart 2001; 86 : 167-171

17. Philippon F, Plumb VJ, Epstein AE et al. The risk of atrial fibrillation following radiofrequency catheter ablation of atrial flutter. Circulation 1995; 92 : 430-435

18. Saoudi N, Nair M, Abdelazziz A et al. Electrocardiographic patterns and results of radiofrequency catheter ablation of clockwise type I atrial flutter. J Cardiovasc Electrophysiol 1996;7 :931-42

19. Loutrianakis E, Barakat T, Olshansky B. Early versus late atrial fibrillation after atrial flutter ablation. J Interv Card Electrophysiol 2002; 6 : 173-180

20. Da Costa A, Romeyer C, Mourot S et al. Factors associated with early atrial fibrillation after ablation of common atrial flutter. Eur Heart J 2002; 23 : 498-506

21. Paydak H, Kall J, Burke M et al. Atrial fibrillation after radiofrequency ablation of type I atrial flutter : time to onset, determinants, and clinical course. Circulation 1998;98 :315-22

22. Da Costa A, Mourot S, Roméyer-Bouchard C, Thévenin J, Samuel B, Kihel A, Isaaz K. Anatomic and electrophysiological differences between chronic and paroxysmal forms of common atrial flutter and comparison with controls: an observational study. PACE 2004; 27; 1202-1211

Metadata

Repository Staff Only: item control page