Cited by 134Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmias

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Incidence of atrial fibrillation post-cavotricuspid isthmus ablation in patients with typical atrial flutter: left-atrial size as an independent predictor of atrial fibrillation recurrence

ELLIS, KEITH, WAZNI, OUSSAMA, MARROUCHE, NASSIR, MARTIN, DAVID, GILLINOV, MARC, McCARTHY, PATRICK, SAAD, EDUARDO B., BHARGAVA, MANDEEP, SCHWEIKERT, ROBERT, SALIBA, WALID, BASH, DIANNA, ROSSILLO, ANTONIO, ERCIYES, DEMET, TCHOU, PATRICK, NATALE, ANDREA·2007·Journal of Cardiovascular Electrophysiology

DOI 10.1111/j.1540-8167.2007.00885.x

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Abstract

INTRODUCTION: Atrial fibrillation and atrial flutter often coexist. The long-term occurrence of atrial fibrillation in patients presenting with atrial flutter alone is unknown. We report the long-term follow-up in patients who underwent cavotricuspid isthmus ablation for treatment of lone atrial flutter. METHODS AND RESULTS: Between January 1997 and June 2002, 632 patients underwent cavotricuspid isthmus ablation for the treatment of typical atrial flutter at the Cleveland Clinic Foundation. Three hundred sixty-three patients were included in this study and followed for a mean duration of 39 +/- 11 months. The mean duration of atrial flutter symptoms was 12 +/- 5 months. Mean left-atrial size and left-ventricular ejection fraction were 4.2 +/- 0.8 cm and 47 +/- 13%, respectively. After a mean follow-up time of 39 +/- 11 months, 13% (48 of 363) of the patients remained in sinus rhythm. Five percent (18 of 363) of patients experienced recurrence of atrial flutter only. Sixty-eight percent (246 of 363) experienced the onset of atrial fibrillation and 14% (51 of 363) experienced recurrence of atrial flutter and the new onset of atrial fibrillation. Overall, 82% (297 of 363) of the patients experienced new onset of drug refractory atrial fibrillation. Left-atrial size was a predictor of atrial fibrillation recurrence post-atrial flutter ablation. CONCLUSION: At long-term follow-up, approximately 82% of patients post-cavotricuspid isthmus ablation for atrial flutter developed drug refractory atrial fibrillation. This finding suggests that elimination of atrial flutter might delay, but does not prevent, atrial fibrillation. Evidence suggests both arrhythmias may share common triggers and such patients may derive a better long-term benefit from anatomical ablative treatment of atrial fibrillation as well.

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Authors: ELLIS, K., WAZNI, O., MARROUCHE, N., MARTIN, D., GILLINOV, M., McCARTHY, P., SAAD, E. B., BHARGAVA, M., SCHWEIKERT, R., SALIBA, W., BASH, D., ROSSILLO, A., ERCIYES, D., TCHOU, P., & NATALE, A.
Affiliations: Cleveland Clinic (US)
Corresponding author: NATALE, ANDREA
ORCID: WAZNI, OUSSAMA
MARROUCHE, NASSIR
MARTIN, DAVID
GILLINOV, MARC
McCARTHY, PATRICK
SAAD, EDUARDO B.
BHARGAVA, MANDEEP
SALIBA, WALID
ROSSILLO, ANTONIO
ERCIYES, DEMET
TCHOU, PATRICK
NATALE, ANDREA
Venue: Journal of Cardiovascular Electrophysiology
Publisher: Wiley
Published: 2007-06-25
Volume: 18
Issue: 8
Pages: 799-802
ISSN: 1045-3873 (ISSN-L)
1540-8167
DOI: 10.1111/j.1540-8167.2007.00885.x
OpenAlex: W2060097624
Cited by: 134
References: 19
Citations by year: 2026: 3 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 15 · 2014: 9 · 2013: 10 · 2012: 6
FWCI: 6.34
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Cardiovascular Electrophysiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: atrial fibrillation, atrial flutter, cavotricuspid isthmus ablation, left atrial size, atrial fibrillation recurrence, drug-refractory atrial fibrillation, long-term follow-up, left ventricular ejection fraction, atrial fibrillation triggers
MeSH terms: Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Female, Heart Atria, Humans, Male, Middle Aged, Ohio, Prognosis, Recurrence, Risk Factors, Sensitivity and Specificity, Tricuspid Valve, Reproducibility of Results, Comorbidity, Incidence, Catheter Ablation, Risk Assessment

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Incidence of atrial fibrillation post-cavotricuspid isthmus ablation in patients with typical atrial flutter: left-atrial size as an independent predictor of atrial fibrillation recurrence

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