title: Evaluation of factors affecting persistence of atrial fibrillation in patients with concomitant atrial flutter treated with percutaneous radiofrequency current ablation of the right atrial cavotricuspid isthmus.
abstract: BACKGROUND
  Atrial fibrillation (AF) and atrial flutter (AFL) often coexist. In some patients, AF remission is seen after successful percutaneous radiofrequency current ablation of the cavotricuspid isthmus (CTI).
  
  
  OBJECTIVE
  To evaluate factors affecting AF remission in patients with typical AFL and concomitant AF who underwent CTI ablation.
  
  
  METHODS
  The study included consecutive 69 patients with typical AFL and concomitant clinically documented AF who underwent successful CTI ablation in 2003-2010. Based on the follow-up data from medical records and telephone interviews, the patients were divided into two groups: with persistent AF (group A) and with remission of AF (group B). This distinction was based on arrhythmia symptoms reported by the patient, such as palpitation or irregular heartbeat, and confirmed electrocardiographically (12-lead ECG or Holter monitoring).
  
  
  RESULTS
  Group A included 47 patients, and group B included 22 patients. The two groups did not differ significantly in regard to the New York Heart Association (NYHA) functional class and concomitant diseases including diabetes, ischaemic heart disease, previous myocardial infarction and arterial hypertension. The two groups also did not differ by echocardiographically determined mean left ventricular ejection fraction (LVEF) and left atrial dimension (43.5 ± 9.27 vs. 39.27 ± 5.76, p = 0.075). Multivariate logistic regression did not identify any independent risk factors of AF persistence after CTI ablation. Univariate logistic regression also did not show arterial hypertension, type 2 diabetes, previous myocardial infarction, LVEF, left ventricular dimension or age to affect AF persistence after successful ablation.
  
  
  CONCLUSIONS
  Based on the results of our study, we were unable to identify factors determining remission of AF coexisting with AFL in patients after percutaneous CTI ablation. These findings may indicate the need for complex ablation procedure (involving both CTI and pulmonary venous ostia ablation) in patients in whom these two arrhythmias coexist.
authors.affiliation: Students Scientific Circle, Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian University of Medicine, Silesian Centre for Heart Diseases. pawel.chodor@gmail.com.
authors.forename: Paweł
authors.initials: P
authors.lastname: Chodór
authors.forename: Beata
authors.initials: B
authors.lastname: Białkowska
authors.forename: Beata
authors.initials: B
authors.lastname: Hapeta
authors.forename: Kamil
authors.initials: K
authors.lastname: Bugała
authors.forename: Jan
authors.initials: J
authors.lastname: Kłyś
authors.forename: Patrycja
authors.initials: P
authors.lastname: Pruszkowska-Skrzep
authors.forename: Beata
authors.initials: B
authors.lastname: Sredniawa
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D001282:Atrial Flutter / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents