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KMID : 1011920140150030004
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International Journal of Arrhythmia
2014 Volume.15 No. 3 p.4 ~ p.12
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Prognosis of Atrial Flutter Alone Ablation in Patients who Show Typical Atrial Flutter with or without Rarely Documented Paroxysmal Atrial Fibrillation
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Cho Eun-Jeong
Lee Sung-Ho
Park Seung-Jung
Kim Jun-Soo
On Young-Keun
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Abstract
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Introduction: Cavotricuspid isthmus (CTI)-dependent typical atrial flutter (AFL) is often accompanied by paroxysmal or subclinical atrial fibrillation (AF). Herein, we assessed the prognosis of only CTI ablation in patients with typical AFL with or without rarely documented paroxysmal AF (PAF) episodes.
Methods: CTI ablation alone was performed in 36 consecutive patients (age, 63.3 ± 1.3 years; 34 men), of whom 26 had typical AFL alone (AFL-alone group) and 10 had mainly typical AFL with rarely documented PAF episodes (mixed group) prior to ablation. Recurrence of AF/AFL was assessed using 12-lead and Holter electrocardiograms during the follow-up period (mean, 21 months) after CTI ablation.
Results: The mean follow-up duration was 20.8 ± 17.3 months. In the AFL-alone group, recurrence of atrial achyarrhythmia was noted in 9 (34.6%) patients. AFL recurrence and new-onset AF were noted in 8 (30.8%) and 2 (7.5%) patients, respectively. In the mixed group, atrial arrhythmia was noted in 9 (90%) patients. AFL and AF recurrence were noted in 5 (50%) and 5 (50%) patients, respectively. Concomitant AF at baseline, increased left atrial diameter, and dyslipidemia were associated with the recurrence of atrial tachyarrhythmia.
Conclusion: Close, regular follow-up might be needed for patients with typical AFL after CTI ablation because of the high recurrence of atrial tachyarrhythmia. In addition to CTI ablation, more aggressive treatment such as pulmonary vein isolation might be needed for patients presenting with mainly typical AFL and rare PAF episodes.
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KEYWORD
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prognosis, atrial flutter, atrial fibrillation, ablation
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