Document Detail


Incidence of atrial fibrillation during very long-term follow-up after radiofrequency ablation of typical atrial flutter.
MedLine Citation:
PMID:  19664572     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Radiofrequency ablation is an effective treatment for typical atrial flutter (AFL) but long-term results may be hampered by atrial fibrillation (AF).
AIMS: To determine the incidence and predictors of AF during very long-term follow-up after radiofrequency ablation of typical AFL.
METHODS: From November 1998 to December 2000, patients who underwent successful radiofrequency ablation for cavotricuspid isthmus-dependent AFL in our centre were followed prospectively.
RESULTS: Of the 135 patients followed (mean age: 62+/-11 years), 69 (51%) had structural heart disease. Mean left ventricular ejection fraction was 52+/-11%. Patients were analysed according to preablation AF history: group 1 included patients with AFL (N=71); group 2 included patients with AFL and AF (N=64). During a median [interquartile range] follow-up of 7.8 [7.0-8.4] years, new-onset or recurrent AF was experienced by 99 (73%) patients: 44 (62%) in group 1 and 55 (86%) in group 2. Although most episodes occurred in the first 2 years postablation, AF prevalence increased continuously over time. Preablation AF history predicted AF occurrence (hazard ratio: 2.10, 95% confidence interval: 1.40-3.14; p=0.001), as did left atrial diameter (hazard ratio: 1.05 per 1 mm increase; 95% confidence interval: 1.02-1.08; p<0.001). AF evolved to become permanent in 24% of group 1 and 47% of group 2 patients (p=0.005).
CONCLUSION: During long-term follow-up, most patients will experience AF after ablation of typical AFL. Preablation AF history and left atrial enlargement predict postablation AF occurrence.
Authors:
Ghassan Moubarak; Dominique Pavin; Bruno Laviolle; Aude Solnon; Gaëlle Kervio; Jean-Claude Daubert; Philippe Mabo
Publication Detail:
Type:  Journal Article     Date:  2009-05-29
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  102     ISSN:  1875-2136     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:    2009 Jun-Jul
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-12-11     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  525-32     Citation Subset:  IM    
Affiliation:
Département de cardiologie et des maladies vasculaires, centre hospitalo-universitaire de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 09, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / epidemiology,  etiology*,  pathology,  physiopathology
Atrial Flutter / epidemiology,  pathology,  physiopathology,  surgery*
Catheter Ablation / adverse effects*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Prevalence
Proportional Hazards Models
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

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


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