Abstract 16723: Variation in Atrial Fibrillation Incidence After Atrial Flutter Ablation According to Follow-up Characteristics: Meta-analysis Study
Background: Atrial Flutter (AFL) is usually initiated with short bursts of Atrial Fibrillation (AF). New-onset atrial fibrillation (AF) after catheter ablation for typical atrial flutter (AFL) has been described in prior studies with significant variation in AF incidence rate. We hypothesized that the variation in the incidence rate depends on the characteristics of the post-ablation follow-up: type and duration of follow up.
Methods: We performed a meta-analysis by searching online databases for articles from January 1996 to April 2015, and abstracts in the last 2 years which described patients with new AF after successful typical AFL ablation (Complete bidirectional block). We evaluated AF incidence rate based on duration of follow-up in patients who were followed by ECG, clinic visit and Holter monitoring for < 7 days per year. We also evaluated AF rates in studies with < 2 years follow-up based on type of follow-up by categorizing them in 3 groups: Group 1 included ECG, clinical follow-up and symptom-driven evaluation, Group 2 additionally included scheduled 24-hour Holter monitoring for < 7 days per year regardless of symptoms, group 3 included scheduled > 7 days Holter monitoring per year or patients with implant loop recorder.
Results: A total of 49 studies were included (5452 patients, typical AFL ablation success rate: 95% and no prior AF). Total incidence of new-onset AF was 29% for a weighted mean follow-up of 30 months. Incidence of AF correlated with duration of follow-up as illustrated in the bubble regression plot (figure 1). The incidence of AF was 12.4% in group 1 (755 patients), 19.3% in group 2 (357 patients), 45% in group 3 (178 patients). Mean follow-up duration was 15.2, 18, and 16.4 months respectively.
Conclusions: The incidence rate of AF after AFL ablation in patients with no prior history of AF, significantly increases with time. Closer monitoring detects a higher rate of AF during short duration follow-up.
Author Disclosures: M. Pino: None. O.L. Llanos: None. A. Hakeem: None. K. Ayoub: None. A. Abualsuod: None. R. Nairooz: None. N.V. Pothineni: None. W. Maskoun: None.
- © 2015 by American Heart Association, Inc.