Abstract 10832: New-Onset Atrial Fibrillation is Common After Radiofrequency Ablation for Isolated Typical Atrial Flutter
Introduction: Radiofrequency ablation (RFA) is considered a curative procedure for typical atrial flutter (AFL). However, post-RFA these pts are still at risk for developing atrial fibrillation (AF) due to risk factors common to both arrhythmias. We sought to determine the incidence and predictors of new-onset AF and stroke after successful RFA of isolated, typical AFL.
Methods: We included 271 consecutive pts who underwent successful RFA of isolated, typical AFL from 2006 to 2012 at 3 community and teaching hospitals. Patients with a history of AF prior to RFA were not included in this cohort.
Results: Patients were 65 ± 12 years old, 27% had chronic obstructive pulmonary disease, 31% had obstructive sleep apnea, 55% had body mass index (BMI) ≥ 30, and 33% had ejection fraction < 50%. Mean CHADS2 score was 1.9 ± 1.2. Anticoagulation was stopped in 63% of pts 3.2 ± 4.9 months after RFA. During 2.4 ± 1.7 years of follow-up, 67 (25%) pts developed new AF. Pts who developed AF were more likely to have BMI ≥ 30, heart failure and left atrial dilatation (Table 1). There was also a trend for higher AF incidence in older pts and those with obstructive sleep apnea. Stroke occurred in 11 (4%) pts during follow-up. In 5 of these 11 pts, warfarin had been stopped after RFA and in 5 pts AF had occurred.
Conclusions: New-onset AF is common after RFA of isolated, typical AFL, particularly in older pts with obesity, heart failure, left atrial dilatation and sleep apnea. Despite successful RFA, risk of stroke remains elevated in these pts.
- © 2013 by American Heart Association, Inc.