Document Detail

Atrial fibrillation is common after ablation of isolated atrial flutter during long-term follow-up.
MedLine Citation:
PMID:  17675077     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous studies have shown that the incidence of atrial fibrillation after atrial flutter ablation is approximately 20% among patients presenting with typical atrial flutter and no history of fibrillation. However, studies involving this population have been small, with follow-up typically less than 2 years. OBJECTIVE: The purpose of this study was to provide a more accurate perspective on the long-term risk of atrial fibrillation in patients presenting with isolated typical flutter. METHODS: Clinical records of consecutive patients who had flutter ablations at Presbyterian Medical Center between 1999 and 2004 were assessed (n = 254). Patients with no apparent history of atrial fibrillation before their flutter ablation were identified. Retrospective follow-up data on these patients were obtained by review of medical records from our institution, from patients' cardiologists and primary care physicians, and by direct patient questionnaires. Postablation atrial fibrillation and other arrhythmias were identified by electrocardiography, Holter monitoring, and subsequent clinical records. RESULTS: Postablation atrial fibrillation was identified in 40 (50%) of 80 patients, and an additional three patients presented with atypical atrial flutter, after a mean follow-up of 29.6 +/- 21.7 months. The incidence of atrial fibrillation was progressive, with 49% occurring after 2 years. There was no difference in age, left atrial size, hypertension, structural heart disease, or left ventricular dysfunction in patients who developed atrial fibrillation compared with those who did not. CONCLUSION: Atrial fibrillation occurs in over half of patients who present with isolated typical flutter after cavotricuspid isthmus ablation. Asymptomatic patients should be screened for recurrent arrhythmias indefinitely after ablation. In certain patients, atrial fibrillation and flutter may be different expressions of the same electrical disease, and eradication of the flutter circuit will not prevent the eventual manifestation of atrial fibrillation.
Jason S Chinitz; Edward P Gerstenfeld; Francis E Marchlinski; David J Callans
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Publication Detail:
Type:  Journal Article     Date:  2007-04-10
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  4     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-06     Completed Date:  2007-10-09     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1029-33     Citation Subset:  IM    
Division of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / epidemiology*,  physiopathology
Atrial Flutter / physiopathology,  surgery*
Catheter Ablation*
Heart Conduction System / physiopathology
Middle Aged
Postoperative Complications / epidemiology*
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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