Abstract 15814: Risk of Arrhythmia Recurrence in Patients With Typical Atrial Flutter With Proven Pulmonary Vein Antrum Isolation or Persistent Cavo-tricuspid Isthmus Block
Introduction: Cavo-tricuspid isthmus isolation (CTI) effectively targets typical atrial flutter (AFL) with a reported success rate of >85%. However, the incidence of new-onset atrial fibrillation (AF) following CTI remains high at around 50%.
Objective: This study examined the risk of AF and AFL in patients undergoing pulmonary vein antrum isolation (PVAI) or CTI for typical AFL only.
Methods: Forty-seven consecutive patients that have received either CTI only (group 1: n=21, 63.7±7.1 year, 75% male) or PVAI (group 2: n=26, 64.5±5.7 year, 73% male) for lone typical AFL were enrolled in this prospective analysis. Three months after the index ablation, a second procedure was performed to confirm persistent isolation of PVs and CT block. All patients were followed up for recurrence for 19±7 months after the second procedure with event-recorders and 7-day Holter monitoring.
Results: Baseline characteristics were similar between the two groups. During the second procedure, persistence of isolation was confirmed in all patients except 1 from group 1 (95%) and in 22 of 26 (84.6%) patients in group 2. Only those subjects that had persistent CT block and PV-isolation (group 1: 20 and group 2: 22) were followed up for this analysis. At the end of 19±7 months, 1 patient from group 1 (5%) and 2 from group 2 (9%) had recurrence of typical AFL (p=0.99) whereas new-onset AF was detected in 10 (50%) and 3 (13.6%) patients from group 1 and 2 respectively (p=0.01).
Conclusion: Our findings suggest that pulmonary vein triggers play an important role in atrial flutter and PVAI successfully prevents the recurrence of both AF and AFL compared to CTI only in patients presenting with lone typical atrial flutter.
Author Disclosures: S. Mohanty: None. L. Di Biase: Speakers Bureau; Modest; Biotronik, EpiEP, Medtronic, Inc., Janssen Pharmaceuticals, Pfizer, Inc., Boston Scientific Corp.. Consultant/Advisory Board; Modest; Biosense Webster, Inc., St Jude Medical, Stereotaxis, Inc.. C. Trivedi: None. C. Gianni: None. J. Burkhardt: None. J.E. Sanchez: None. A. Al-Ahmad: None. R. Horton: None. G. Pellargonio: None. G. Forleo: None. S. Themistoclakis: None. M. Casella: None. A. Dello Russo: None. C. Tondo: None. A. Natale: Speakers Bureau; Modest; Boston Scientific Corp, Biotronik, Medtronic, Inc., Biosense Webster, Inc, St. Jude Medical. Consultant/Advisory Board; Modest; Janssen Pharmaceuticals, St. Jude Medical, Biosense Webster Inc..
- © 2016 by American Heart Association, Inc.