title: Prevalence and electrophysiological characteristics of typical atrial flutter in patients with atrial fibrillation and chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is one of the important underlying diseases of atrial fibrillation (AF). However, the prevalence and electrophysiological characteristics of typical atrial flutter (AFL) in patients with AF and COPD remain unknown. The purpose of the present study was to investigate those characteristics.
  
  
  RESULTS
  We investigated 181 consecutive patients who underwent catheter ablation of AF. Twenty-eight patients were diagnosed with COPD according to the Global Initiatives for Chronic Obstructive Lung Disease (GOLD) criteria. Forty patients with no lung disease served as a control group. We analysed the electrophysiological characteristics in these groups. Typical AFL was more common in the COPD group (19/28, 68%) than in the non-COPD group (13/40, 33%; P = 0.006). The prevalence of AFL increased with the severity of COPD: 4 (50%) of 8 patients with GOLD1, 13 (72%) of 18 patients with GOLD2, and 2 (100%) of 2 patients with GOLD3. Atrial flutter cycle length and conduction time from the coronary sinus (CS) ostium to the low lateral right atrium (RA) during CS ostium pacing before and after the cavotricuspid isthmus ablation were significantly longer in the COPD group than in the non-COPD group (285 vs. 236, 71 vs. 53, 164 vs. 134 ms; P = 0.009, 0.03, 0.002, respectively).
  
  
  CONCLUSIONS
  In COPD patients with AF, conduction time of RA was prolonged and typical AFL was commonly observed.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan.
authors.forename: Takekuni
authors.initials: T
authors.lastname: Hayashi
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukamizu
authors.forename: Rintaro
authors.initials: R
authors.lastname: Hojo
authors.forename: Kota
authors.initials: K
authors.lastname: Komiyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Tejima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nishizaki
authors.forename: Masayasu
authors.initials: M
authors.lastname: Hiraoka
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Momomura
authors.forename: Harumizu
authors.initials: H
authors.lastname: Sakurada
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016280:Atrial Function, Right; D016022:Case-Control Studies; D017115:Catheter Ablation; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000601:surgery; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; Chronic obstructive pulmonary disease; Radiofrequency catheter ablation; Typical atrial flutter