Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: Long-term follow-up

Background: The aim of the study was identification of the predictors of left atrial tachycardia and left atrial flutter (LATAFL) after radiofrequency catheter ablation of atrial fibrillation (CAAF). Methods: We followed 598 patients (71% male, 41% paroxysmal AF; median follow-up: 36 months) after a single step-wise CAAF procedure. The time to first documented LATAFL lasting longer than 30 s, documented in any kind of electrocardiography (ECG), was defined as an end-point. Results: A single CAAF procedure resulted in LATAF in 58 (10%) patients. Additional lesions were performed in 275 (46%) patients. Early LATAFL recurrence (<= 3 months since the index procedure) was observed in 11 (2%) patients. Late LATAFL (>3 months) was noted in 47 (8%) patients. The univariate predictors of LATAFL recurrence were: type of AF (rho = 0.003), the size of LA (rho = 0.002) and the type of procedure (rho = 0.0001). The identified single independent predictors of LATAFL recurrence were enlarged LA (rho = 0.001) and multiple (>= 2) additional lesions performed during the index procedure (rho < 0.0001). Conclusions: Higher rate of LATAFL recurrence was observed in patients with non-paroxysmal AF, enlarged LA and any additional lesions performed. Two independent predictors of LATAFL recurrence after CAAF were: the enlarged LA and multiple (>= 2) additional lesions performed during the index procedure.