Abstract 16715: Incidence of Atrial Fibrillation After Atrial Flutter Ablation: A Meta-analysis Study
Background: Atrial Flutter (AFL) is usually initiated with short bursts of Atrial Fibrillation (AF). The incidence rate of AF after AFL ablation is variable. We evaluated the occurrence of AF in patients who underwent successful AFL catheter ablation with documented prior AF versus no prior AF.
Methods: A meta-analysis was performed by searching online databases from January 1996 to April 2015 for studies describing patients who underwent typical AFL catheter ablation with and without prior AF.
Results: A total of 36 articles were included, describing 6567 patients with typical AFL (2753 with prior AF and 3814 with no prior AF) who underwent ablation with 95% average success rate (bidirectional block). The overall incidence of AF after ablation was 35.3% (41% prior to ablation) during mean weighted follow-up (f/u) duration of 29.4 months. AF incidence after AFL ablation was 23% in patients with no prior AF and 52% in those with prior AF (OR 3.96, 95% CI [3.174.95] ; p<0.00001). Subgroup analysis based on duration of f/u showed a significant variation of this probability (p=0.0003) between the group with < 2 years f/u, compared to > 2 years f/u due to an increase of AF incidence rate in patients with no prior AF. In studies with < 2 years f/u duration, AF weighted average incidence rate after AFL ablation was 53.6 % in patients with prior AF and 14.3% in those with no prior AF (OR 6.90, 95% CI [4.5410.48] ; p<0.00001). In studies with > 2 years f/u duration, post-ablation AF developed in 51.3% of those with prior AF and in 26.3% of those with no prior AF (OR 2.93, 95% CI [2.423.56] ; p<0.00001). Figure 1
Conclusions: Patients with prior history of AF have a higher incidence of AF after AFL ablation when compared to patients with no prior history of AF. However, this significantly decreases with extended follow-up duration due to an increase of detected AF in patients with no prior history of AF. This finding is important for decisions regarding anticoagulation plan after successful AFL ablation.
Author Disclosures: M. Pino: None. K. Ayoub: None. O.L. Llanos: None. R. Nairooz: None. A. Abualsuod: None. A. Hakeem: None. N.V. Pothineni: None. H. Paydak: None. W. Maskoun: None.
- © 2015 by American Heart Association, Inc.