title: Risk of atrial fibrillation after atrial flutter ablation: impact of AF history, gender, and antiarrhythmic drug medication.
abstract: BACKGROUND
  Atrial fibrillation (AF) and flutter (AFL) are frequently associated. We assessed the frequency and identified the predictors of AF occurrence after AFL ablation.
  
  
  RESULTS
  A total of 1,121 patients referred for AFL ablation were followed for a mean duration of 2.1 ± 2.7 years. Antiarrhythmic drugs were stopped after ablation in patients with no AF prior to ablation, or continued otherwise. A total of 356 patients (31.7%) had a history of AF prior to AFL ablation. Patients with AF prior to ablation were more likely to be females (OR = 1.35, CI = 1.00-1.83, P = 0.05). After ablation, 260 (23.2%) patients experienced AF. In the multivariable model, AF prior to ablation (OR = 1.90, CI = 1.42-2.54, P < 0.001) and female gender (OR = 1.77, CI = 1.29-2.42, P < 0.001) were associated with a higher risk of AF after ablation. In patients without prior AF, class I antiarrhythmics and amiodarone prior to AFL ablation were independently associated with higher risk of AF after ablation (OR = 2.11, CI = 1.15-3.88, P = 0.02 and OR = 1.60, CI = 1.08-2.36, P = 0.02, respectively). In patients who experienced AF after ablation, 201/260 (77.3%) had a CHA2DS2-VASc ≥1. Two patients with AF prior to ablation had a stroke during the follow-up whereas none of the patients without AF prior to ablation had a stroke.
  
  
  CONCLUSIONS
  AF occurrence after AFL ablation is frequent (>20%), especially in patients with a history of AF, in female patients, and in patients treated with class I antiarrythmics/amiodarone prior to AFL. Since most patients who experience AF after AFL ablation have a CHA2DS2-VASc ≥1, the decision to stop anticoagulants after ablation should be considered on an individual basis.
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Brembilla-Perrot
authors.affiliation: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, Institut Lorrain du cœur et des vaisseaux, CHU de Nancy, Nancy, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Sellal
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Olivier
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Manenti
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Villemin
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Beurrier
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Christian
authors.initials: C
authors.lastname: DE Chillou
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Louis
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Selton
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-les-Nancy, France.
authors.forename: Arnaud Terrier
authors.initials: AT
authors.lastname: DE LA Chaise
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D016009:Chi-Square Distribution; D004617:Embolism / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: ablation; antiarrhythmic drugs; atrial fibrillation; atrial flutter