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Cited by 20Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery

AKTAS, MEHMET K., KHAN, MOHAMMED N., DI BIASE, LUIGI, ELAYI, CLAUDE, MARTIN, DAVID, SALIBA, WALID, CUMMINGS, JENNIFER, SCHWEIKERT, ROBERT +1 more·2010·Journal of Cardiovascular Electrophysiology
DOI 10.1111/j.1540-8167.2009.01709.x
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Abstract

INTRODUCTION: Atrial flutter (AFL) is common after cardiac surgery. However, the types of post-cardiac surgery AFL, its response to catheter-based radiofrequency ablation, and its relationship to atrial fibrillation (AF) are unknown. METHODS AND RESULTS: We retrospectively studied all patients who underwent mapping and ablation for AFL after cardiac surgery from January 1990 to July 2004. One hundred randomly selected patients without prior cardiac surgery (PCS) who underwent mapping and ablation of AFL served as the control population. A total of 236 patients formed the study population (mean age 62 + 13 years, 22% female) and 100 patients formed the control population (mean age 60 + 13 years, 25% female). The majority of patients without PCS had cavo-tricuspid isthmus (CTI)-dependent AFL when compared to patients with PCS (93% vs 72%, respectively, P < 0.0001). In contrast, scar-related AFL was more common in patients with PCS as compared to patients without PCS (22% vs 3%, P < 0.0001). Predictors of scar related AFL in multivariable regression analysis included PCS and left-sided AFL. Acute success rates and complications were similar between the groups. When compared to patients with AFL ablation without PCS, those that had AFL after PCS had higher rates of recurrence of both AFL (1% vs 12%, P < 0.0001; mean time to recurrence 1.85 years) and AF (16% vs 28%, P = 0.02; mean time to recurrence 2.67 years). CONCLUSION: Despite ablation of AFL, patients with PCS have a higher rate of AFL and AF when compared to patients without PCS who underwent ablation of atrial flutter during long-term follow-up.

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Authors
AKTAS, M. K., KHAN, M. N., DI BIASE, L., ELAYI, C., MARTIN, D., SALIBA, W., CUMMINGS, J., SCHWEIKERT, R., & NATALE, A.
Affiliations
  • University of Kentucky (US)
  • Cleveland Clinic (US)
  • Cleveland Clinic Akron General (US)
  • St David's Medical Center (US)
Corresponding author
  • MARTIN, DAVID
  • NATALE, ANDREA
ORCID
Venue
Journal of Cardiovascular Electrophysiology
Publisher
Wiley
Published
2010-06-25
Volume
21
Issue
7
Pages
760-765
ISSN
  • 1045-3873 (ISSN-L)
  • 1540-8167
DOI
10.1111/j.1540-8167.2009.01709.x
OpenAlex
W2160959046
Cited by
20
References
43
Citations by year
2022: 3 · 2021: 3 · 2020: 3 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 1 · 2012: 2
FWCI
0.88
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 › 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 flutter, atrial fibrillation, cardiac surgery, radiofrequency catheter ablation, postoperative arrhythmia, atrial flutter recurrence
MeSH terms
Aged, Atrial Fibrillation, Atrial Flutter, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Recurrence, Retrospective Studies, Risk Factors, Time Factors, Chi-Square Distribution, Logistic Models, Odds Ratio, Case-Control Studies, Treatment Outcome, Catheter Ablation, Risk Assessment

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