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Baylor University Medical Center Proceedings
The peer-reviewed journal of Baylor Scott & White Health
Volume 31, 2018 - Issue 3
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Original Research

Frequency of atrial arrhythmias after atrial flutter ablation and the effect of presenting rhythm on the day of ablation

, BDS, MPH, PhD, , MD, , BS, , MD, MPH & , MD
Pages 280-283 | Received 07 Feb 2018, Accepted 09 Apr 2018, Published online: 14 May 2018
 

ABSTRACT

Radiofrequency catheter ablation of the cavotricuspid isthmus is a proven therapy for typical atrial flutter (AFl); however, in some patients, new atrial arrhythmias (AA) may occur after AFl ablation. This study explored the difference in the occurrence of spontaneous AA after AFl ablation as a function of the patient's presenting rhythm on the day of the AFl ablation. A retrospective study of consecutive patients who underwent AFl ablation at Baylor University Medical Center at Dallas was performed. A total of 188 subjects were included; 50% (94) presented in AFl (Group AFl) on the day of the ablation procedure and 94 presented in sinus rhythm (SR; Group SR). Group AFl patients were older (P < 0.001), more likely to have diabetes (P = 0.03), and more likely to have undergone previous heart surgery (P = 0.03). The median size of the left atrium was 4 cm (range 2.8–6.8) in Group AFl compared with 3.8 cm (range 2.6–5.6) in Group SR (P = 0.009). Atrial fibrillation was induced during the ablation procedure in 7.5% and 21.3% of patients in Groups AFl and SR, respectively (P = 0.007). Overall, 29 of 188 (15.4%) patients developed new AA within 1 year of the procedure, 13.8% in Group AFl vs 17.0% in Group SR (P = 0.57). In conclusion, patients presenting for AFl ablation in SR were younger and healthier but had more atrial fibrillation induced during their ablation procedure, with a trend toward more postablation AA due to additional arrhythmia substrate.

Additional information

Funding

This work was funded in part by the Baylor Healthcare System Foundation.

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