Risk of atrial fibrillation, stroke, and death after radiofrequency catheter ablation of typical atrial flutter
Open accessAbstract
Objective The purpose of this study was to assess the incidence, predictors, and prognostic clinical impact of atrial fibrillation (AF) over time after cavotricuspid isthmus (CTI) ablation of typical atrial flutter (AFL).Methods This was a follow-up observational study using 408 patients who underwent CTI AFL ablation between 1998 and 2010. The relationships between the different predictors and the outcomes (AF, stroke, and death) were modeled by means of multistate Cox model analyses.Results The incident rate of AF per 100 person-years during follow-up was 10.2 (95 % CI 8.7-11.8). Prior AF and chronic obstructive pulmonary disease (COPD) were the only independent variables to predict AF occurrence in the population. Their hazard ratios (HRs) were 2.55 (95 % CI 1.84-3.52) and 1.56 (95 % CI 1.08-2.27), respectively. Patients who transitioned to AF had an increased risk of death by an HR of 2.82 (95 % CI 1.88-4.70) and an increased risk of stroke by an HR of 2.93 (95 % CI 1.12-8.90). Age, COPD, and heart failure (HF) were predictive factors of death by HRs of 1.05 (95 % CI 1.00-1.08), 2.85 (95 % CI 1.39-5.83), and 2.72 (95 % CI 1.15-6.40), respectively. Age, smoking, COPD, and HF were predictive factors of death in the group of patients with AF during follow-up. HRs were 1.07 (95 % CI 1.02-1.12), 2.55 (95 % CI 1.55-4.21), 7.60 (95 % CI 3.01-19.16), and 3.07 (95 % CI 1.18-7.95), respectively.Conclusions The transition to AF after CTI AFL ablation was high during a long-term follow-up period and maintained over time. Prior AF and COPD were the primary predictors of transition to AF after CTI AFL ablation. Patients who transitioned to AF had an increased risk of stroke and a more than twofold mortality rate. These clinical implications make it necessary to investigate AF after CTI ablation.
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Many patients diagnosed with atrial flutter develop AF.
“Furthermore, many patients diagnosed with atrial flutter develop AF. [993][994][995]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [994]
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- Authors
- Seara, J. G., Roubin, S. R., Gude Sampedro, F., Barreiro, V. B., Sande, J. M., Mañero, M. R., Grandio, P. C., Alvarez, B., & Juanatey, J. G.
- Affiliations
- Complejo Hospitalario Universitario de Santiago (ES)
- Corresponding author
- Seara, Javier García
- Venue
- Clinical Research in Cardiology
- Published
- 2014-02-25
- Volume
- 103
- Issue
- 7
- Pages
- 543-552
- ISSN
- 1861-0684 (ISSN-L)
- 1861-0692
- OpenAlex
- W2066383701
- Cited by
- 53
- References
- 27
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 5 · 2022: 1 · 2021: 4 · 2020: 6 · 2019: 8 · 2018: 5 · 2017: 3 · 2016: 8 · 2015: 5 · 2014: 1
- FWCI
- 3.89
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Clinical Research in Cardiology (publishedVersion)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- RUNA. Repositorio Institucional del Sergas (Servicio Gallego de Salud (SERGAS)) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial fibrillation, typical atrial flutter, radiofrequency catheter ablation, cavotricuspid isthmus ablation, post-ablation atrial fibrillation, stroke, mortality, chronic obstructive pulmonary disease, heart failure, smoking, predictors of atrial fibrillation, long-term prognosis, multi-state models, age as risk factor
- MeSH terms
- Age Factors, Aged, Atrial Fibrillation, Atrial Flutter, Female, Follow-Up Studies, Heart Failure, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Smoking, Time Factors, Incidence, Catheter Ablation, Stroke, Pulmonary Disease, Chronic Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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