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


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.


CONCLUSIONS
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.
Cade
Stéphane
S
Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire, Montpellier, France.
Sedighian
Shahine
S
Bortone
Agustin
A
Gervasoni
Richard
R
Macia
Jean Christophe
JC
Leclercq
Florence
F
Grolleau
Robert
R
Pasquié
Jean Luc
JL