Ablation outcomes for atypical atrial flutter versus recurrent atrial fibrillation following index pulmonary vein isolation

被引：6

作者：

Akhtar, Tauseef ^{[1
]}

Daimee, Usama A. ^{[1
]}

Sivasambhu, Bhradeev ^{[1
]}

Boyle, Thomas A. ^{[1
]}

Arbab-Zadeh, Armin ^{[1
]}

Marine, Joseph E. ^{[1
]}

Berger, Ronald ^{[1
]}

Calkins, Hugh ^{[1
]}

Spragg, David ^{[1
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Div Cardiol, Baltimore, MD USA

来源：

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY | 2021年 / 32卷 / 06期

关键词：

atrial fibrillation; atypical atrial flutter; left atrial volume index; perimitral atrial flutter; radiofrequency ablation; roof dependent atrial flutter; CATHETER ABLATION; RADIOFREQUENCY; TACHYCARDIA; CRYOBALLOON;

D O I：

10.1111/jce.15051

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Data related to electrophysiologic characteristics of atypical atrial flutter (AFL) following atrial fibrillation (AF) ablation and its prognostic value on repeat ablation success are limited. Methods We studied consecutive patients who underwent a repeat left atrial (LA) ablation procedure for either recurrent AF or atypical AFL, at least 3 months after index AF ablation, between January 2012 and July 2019. The demographics, clinical history, procedural data, complications, and 1-year arrhythmia-free survival rates were recorded for each subject after the first repeat ablation. Results A total of 336 patients were included in our study. Among these 336 patients, 102 underwent a repeat ablation procedure for atypical AFL and 234 underwent a repeat ablation procedure for recurrent AF. The mean age was 63.7 +/- 10.7 years, and 72.6% of patients were men. The atypical AFL cohort had significantly higher LA diameters (4.6 vs. 4.4 cm, p = .04) and LA volume indices (LAVi; 85.1 vs. 75.4 ml/m(2), p = .03) compared to AF patients at repeat ablation. Atypical AFL patients were more likely to have had index radiofrequency (RF) ablation (as opposed to cryoballoon) than recurrent AF patients (98% vs. 81%, p = .01). Atypical AFLs were roof-dependent in 35.6% and peri-mitral in 23.8% of cases. Major complications at repeat ablation occurred in 0.9% of the total cohort. Arrhythmia-free survival at one year was significantly higher in the recurrent atypical AFL compared to the recurrent AF cohort (75.5 vs. 65.0%, p = .04). Conclusion In our series, roof-dependent flutter is the most common form of atypical atrial flutter post AF ablation. Patients developing atypical AFL after index AF ablation have greater LA dimensions than patients with recurrent AF. The success rate of first repeat ablation is significantly higher among patients with recurrent atypical AFL as compared to recurrent AF after index AF ablation.

引用

页码：1631 / 1639

页数：9

共 14 条

[1] Comparison of Regular Atrial Tachycardia Incidence After Circumferential Radiofrequency versus Cryoballoon Pulmonary Vein Isolation in Real-Life Practice [J].

Akerstrom, Finn ;

Bastani, Hamid ;

Insulander, Per ;

Schwieler, Jonas ;

Arias, Miguel A. ;

Jensen-Urstad, Mats .

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2014, 25 (09) :948-952

[2] Arrhythmia Type After Persistent Atrial Fibrillation Ablation Predicts Success of the Repeat Procedure [J].

Ammar, Sonia ;

Hessling, Gabriele ;

Reents, Tilko ;

Fichtner, Stephanie ;

Wu, Jinjin ;

Zhu, Pinjun ;

Kathan, Susanne ;

Estner, Heidi Louise ;

Jilek, Clemens ;

Kolb, Christof ;

Haller, Bernhard ;

Deisenhofer, Isabel .

CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2011, 4 (05) :609-614

[3]

Calkins H, 2017, J ARRYTHM, V33, P369, DOI 10.1016/j.joa.2017.08.001

[4] Updated Worldwide Survey on the Methods, Efficacy, and Safety of Catheter Ablation for Human Atrial Fibrillation [J].

Cappato, Riccardo ;

Calkins, Hugh ;

Chen, Shih-Ann ;

Davies, Wyn ;

Iesaka, Yoshito ;

Kalman, Jonathan ;

Kim, You-Ho ;

Klein, George ;

Natale, Andrea ;

Packer, Douglas ;

Skanes, Allan ;

Ambrogi, Federico ;

Biganzoli, Elia .

CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2010, 3 (01) :32-38

[5] Atrial tachycardia after circumferential pulmonary vein ablation of atrial fibrillation - Mechanistic insights, results of catheter ablation, and risk factors for recurrence [J].

Chae, Sanders ;

Oral, Hakan ;

Good, Eric ;

Dey, Sujoya ;

Wimmer, Alan ;

Crawford, Thomas ;

Wells, Darryl ;

Sarrazin, Jean-Francois ;

Chalfoun, Nagib ;

Kuhne, Michael ;

Fortino, Jackie ;

Huether, Elizabeth ;

Lemerand, Tammy ;

Pelosi, Frank ;

Bogun, Frank ;

Morady, Fred ;

Chugh, Aman .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (18) :1781-1787

[6] Catheter ablation of scar-related atypical atrial flutter [J].

Coffey, James O. ;

d'Avila, Andre ;

Dukkipati, Srinivas ;

Danik, Stephan B. ;

Gangireddy, Sandeep R. ;

Koruth, Jacob S. ;

Miller, Marc A. ;

Sager, Solomon J. ;

Eggert, Charles A. ;

Reddy, Vivek Y. .

EUROPACE, 2013, 15 (03) :414-419

[7] Mechanisms of organized left atrial tachycardias occurring after pulmonary vein isolation [J].

Gerstenfeld, EP ;

Callans, DJ ;

Dixit, S ;

Russo, AM ;

Nayak, H ;

Lin, D ;

Pulliam, W ;

Siddique, S ;

Marchlinski, FE .

CIRCULATION, 2004, 110 (11) :1351-1357

[8] Predictors and Incidence of Atrial Flutter After Catheter Ablation of Atrial Fibrillation [J].

Ipek, Esra Gucuk ;

Marine, Joseph ;

Yang, Eunice ;

Habibi, Mohammadali ;

Chrispin, Jonathan ;

Spragg, David ;

Berger, Ronald D. ;

Calkins, Hugh ;

Nazarian, Saman .

AMERICAN JOURNAL OF CARDIOLOGY, 2019, 124 (11) :1690-1696

[9] Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques [J].

Julia, Justo ;

Chierchia, Gian-Battista ;

de Asmundis, Carlo ;

Mugnai, Giacomo ;

Sieira, Juan ;

Ciconte, Giuseppe ;

Di Giovanni, Giacomo ;

Conte, Giulio ;

Baltogiannis, Giannis ;

Saitoh, Yukio ;

Wauters, Kristel ;

Irfan, Ghazala ;

Brugada, Pedro .

JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2015, 42 (02) :161-169

[10] Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J].

Lang, Roberto M. ;

Badano, Luigi P. ;

Mor-Avi, Victor ;

Afilalo, Jonathan ;

Armstrong, Anderson ;

Ernande, Laura ;

Flachskampf, Frank A. ;

Foster, Elyse ;

Goldstein, Steven A. ;

Kuznetsova, Tatiana ;

Lancellotti, Patrizio ;

Muraru, Denisa ;

Picard, Michael H. ;

Rietzschel, Ernst R. ;

Rudski, Lawrence ;

Spencer, Kirk T. ;

Tsang, Wendy ;

Voigt, Jens-Uwe .

EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2015, 16 (03) :233-271

← 1 2 →