Ablation of perimitral flutter following catheter ablation of atrial fibrillation: impact on outcomes from a randomized study (PROPOSE)

BAI, RONG; BIASE, LUIGI DI; MOHANTY, PRASANT; RUSSO, ANTONIO DELLO; CASELLA, MICHELA; PELARGONIO, GEMMA; THEMISTOCLAKIS, SAKIS; MOHANTY, SANGHAMITRA; ELAYI, CLAUDE S.; SANCHEZ, JAVIER; BURKHARDT, J. DAVID; HORTON, RODNEY; GALLINGHOUSE, G. JOSEPH; BAILEY, SHANE M.; BONSO, ALDO; BEHEIRY, SALWA; HONGO, RICHARD H.; RAVIELE, ANTONIO; TONDO, CLAUDIO; NATALE, ANDREA

doi:10.1111/j.1540-8167.2011.02182.x

Cited by 50Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Ablation of perimitral flutter following catheter ablation of atrial fibrillation: impact on outcomes from a randomized study (PROPOSE)

BAI, RONG, BIASE, LUIGI DI, MOHANTY, PRASANT, RUSSO, ANTONIO DELLO, CASELLA, MICHELA, PELARGONIO, GEMMA, THEMISTOCLAKIS, SAKIS, MOHANTY, SANGHAMITRA +12 more·2012·Journal of Cardiovascular Electrophysiology

DOI 10.1111/j.1540-8167.2011.02182.x

Open this paper in CoChat — free account

Abstract

INTRODUCTION: Patients with previous ablation for atrial fibrillation (AF) may experience recurrence of perimitral flutter (PMFL). These arrhythmias are usually triggered from sources that may also induce AF. This study aims at determining whether ablation of triggers or completing mitral valve isthmus (MVI) block prevents more arrhythmia recurrences. METHODS AND RESULTS: Sixty-five patients with recurrent PMFL after initial ablation of long standing persistent AF were included in this study. Thirty-two patients were randomized to MVI ablation only (Group 1) and 33 were randomized to cardioversion and repeat pulmonary vein (PV) isolation plus ablation of non-PV triggers (Group 2). MVI bidirectional block was achieved in all but 1 patient from Group 1. In Group 2, reconnection of 17 PVs was detected in 14 patients (42%). With isoproterenol challenge, 44 non-PV trigger sites were identified in 28 patients (85%, 1.57 sites per patient). At 18-month follow-up, 27 patients (84%) from Group 1 had recurrent atrial tachyarrhythmias, of whom 15 remained on antiarrhythmic drug (AAD); however, 28 patients from Group 2 (85%, P < 0.0001 vs Group 1) were free from arrhythmia off AAD. The ablation strategy used in Group 2 was associated with a lower risk of recurrence (hazard ratio = 0.10, 95% CI 0.04-0.28, P < 0.001) and an improved arrhythmia-free survival (log rank P < 0.0001). CONCLUSION: In patients presenting with PMFL after ablation for longstanding persistent AF, MVI block had limited impact on arrhythmia recurrence. On the other hand, elimination of all PV and non-PV triggers achieved higher freedom from atrial arrhythmias at follow-up.

Integrity signals

Registry

Crossref · 10.1111/j.1540-8167.2011.02182.x

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Ablation of atypical atrial flutter/macroreentrant tachycardia is more challenging and has a lower success rate and higher recurrence rate than cavotricuspid isthmus ablation.
“Atypical AFL/MRT ablation can be very challenging and has a lower success rate and a higher recurrence rate than CTI ablation.163,164,204 -206”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [206]

Technique and Results of Linear Ablation at the Mitral Isthmus
Jaı̈s, P., Hocini, M., Hsu, L., Sanders, P., Scavée, C., Weerasooriya, R., Macle, L., Raybaud, F., Garrigue, S., Shah, D. C., et al. (2004) · Circulation · doi:10.1161/01.cir.0000146917.75041.58 · Cited by 751 · see citing works
Mapping and ablation of left atrial flutters
Jaïs, P., Shah, D. C., Haïssaguerre, M., Hocini, M., Peng, J. T., Takahashi, A., Garrigue, S., Le Métayer, P., & Clémenty, J. (2000) · Circulation · doi:10.1161/01.cir.101.25.2928 · Cited by 380 · see citing works
Periprocedural Stroke and Management of Major Bleeding Complications in Patients Undergoing Catheter Ablation of Atrial Fibrillation
Biase, L. D., Burkhardt, J. D., Mohanty, P. K., Sánchez, J., Horton, R., Gallinghouse, G. J., Lakkireddy, D., Verma, A., Khaykin, Y., Hongo, R. H., et al. (2010) · Circulation · doi:10.1161/circulationaha.109.921320 · Cited by 293 · see citing works
Self-citation
Circumferential Pulmonary Vein Ablation With Additional Linear Ablation Results in an Increased Incidence of Left Atrial Flutter Compared With Segmental Pulmonary Vein Isolation as an Initial Approach to Ablation of Paroxysmal Atrial Fibrillation
Sawhney, N. S., Anousheh, R., Chen, W., & Feld, G. K. (2010) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.109.924878 · Cited by 248 · see citing works
Left Mitral Isthmus Ablation Associated with PV Isolation: Long‐Term Results of a Prospective Randomized Study
Fassini, G. M., Riva, S. I., Chiodelli, R., Trevisi, N. M., Berti, M., Carbucicchio, C., Maccabelli, G., Giraldi, F., & Bella, P. E. D. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.50192.x · Cited by 244 · see citing works
Characterization of Reentrant Circuits in Left Atrial Macroreentrant Tachycardia: Critical Isthmus Block Can Prevent Atrial Tachycardia Recurrence
Ouyang, F., Ernst, S., Vogtmann, T., Goya, M., Volkmer, M., Schaumann, A., Bänsch, D., Antz, M., & Kuck, K.-H. (2002) · Circulation · doi:10.1161/01.cir.0000015077.12680.2e · Cited by 212 · see citing works
Techniques for Curative Treatment of Atrial Fibrillation
Hocini, M., Sanders, P., Jaı̈s, P., Hsu, L., Takahashi, Y., Rotter, M., Clémenty, J., & Haı̈ssaguerre, M. (2004) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2004.04524.x · Cited by 203 · see citing works
Randomized Study Comparing Combined Pulmonary Vein–Left Atrial Junction Disconnection and Cavotricuspid Isthmus Ablation Versus Pulmonary Vein–Left Atrial Junction Disconnection Alone in Patients Presenting With Typical Atrial Flutter and Atrial Fibrillation
Wazni, O. M., Marrouche, N. F., Martin, D. O., Gillinov, A. M., Saliba, W. I., Saad, E., Klein, A. L., Bhargava, M., Bash, D., Schweikert, R. A., et al. (2003) · Circulation · doi:10.1161/01.cir.0000101684.88679.ab · Cited by 180 · see citing works
Self-citation
Left Atrial Isthmus:
Becker, A. E. (2004) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2004.03651.x · Cited by 175 · see citing works
Peri-mitral atrial flutter in patients with atrial fibrillation ablation
Matsuo, S., Wright, M., Knecht, S., Nault, I., Lellouche, N., Lim, K.-T., Arantes, L., O'Neill, M. D., Hocini, M., Jaïs, P., et al. (2010) · Heart Rhythm · doi:10.1016/j.hrthm.2009.09.067 · Cited by 153 · see citing works
Atrial fibrillation termination as a procedural endpoint during ablation in long-standing persistent atrial fibrillation
Elayi, C. S., Biase, L. D., Barrett, C. D., et al. (2010) · Heart Rhythm · doi:10.1016/j.hrthm.2010.01.038 · Cited by 146 · see citing works
Self-citation
Where to draw the mitral isthmus line in catheter ablation of atrial fibrillation: histological analysis
Wittkampf, F. H. M., van Oosterhout, M. F. M., Loh, P. K. K., Derksen, R., Vonken, E.-J. P. A., Slootweg, P. J., & Ho, S. Y. (2005) · European Heart Journal · doi:10.1093/eurheartj/ehi095 · Cited by 139 · see citing works
Late recurrent arrhythmias after ablation of atrial fibrillation: Incidence, mechanisms, and treatment
Kobza, R., Hindricks, G., Tanner, H., Schirdewahn, P., Dorszewski, A., Piorkowski, C., Gerds‐Li, J., & Kottkamp, H. (2004) · Heart Rhythm · doi:10.1016/j.hrthm.2004.08.009 · Cited by 136 · see citing works
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, K., WAZNI, O., MARROUCHE, N., MARTIN, D., GILLINOV, M., McCARTHY, P., SAAD, E. B., BHARGAVA, M., SCHWEIKERT, R., SALIBA, W., et al. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00885.x · Cited by 134 · see citing works
Atrial fibrillation is common after ablation of isolated atrial flutter during long-term follow-up
Chinitz, J. S., Gerstenfeld, E. P., Marchlinski, F. E., & Callans, D. J. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.04.002 · Cited by 119 · see citing works
The Modified Anterior Line: An Alternative Linear Lesion in Perimitral Flutter
Tzeis, S. E., Luik, A., Jilek, C., Schmitt, C., Estner, H., Wu, J., Reents, T., Fichtner, S., Kolb, C., KARCH, M. R., et al. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2009.01681.x · Cited by 82 · see citing works
Flutter Localized to the Anterior Left Atrium After Catheter Ablation of Atrial Fibrillation
Jaı̈s, P., Sanders, P., Hsu, L., Hocini, M., Sacher, F., Takahashi, Y., Rotter, M., Rostock, T., Bordachar, P., Reuter, S., et al. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.00292.x · Cited by 81 · see citing works
Left Atrial Flutter Following Pulmonary Vein Antrum Isolation with Radiofrequency Energy: Linear Lesions or Repeat Isolation
Cummings, J. E., Schweikert, R. A., Saliba, W. I., Hao, S. C., Martin, D. O., Marrouche, N. F., Burkhardt, J. D., Kılıçaslan, F., Verma, A., Beheiry, S., et al. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2005.40585.x · Cited by 73 · see citing works
Self-citation
Clinical Significance of Early Recurrences of Atrial Tachycardia After Atrial Fibrillation Ablation
Choi, J., Pak, H., Park, J. S., Kwak, J. J., Nagamoto, Y., Lim, H. E., PARK, S. W., Hwang, C., & Kim, Y. (2010) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2010.01831.x · Cited by 63 · see citing works
Left Atrial Flutter After Segmental Ostial Radiofrequency Catheter Ablation for Pulmonary Vein Isolation
Oral, H., Knight, B. P., & Morady, F. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.t01-1-00202.x · Cited by 59 · see citing works
Atrial Arrhythmias After Single-Ring Isolation of the Posterior Left Atrium and Pulmonary Veins for Atrial Fibrillation
Lim, T. W., Koay, C. H., McCall, R., See, V. A., Ross, D. L., & Thomas, S. P. (2008) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.108.769752 · Cited by 53 · see citing works
Mechanism of Spontaneous Transition from Typical Atrial Flutter to Atrial Fibrillation: Role of Ectopic Atrial Fibrillation Foci
HSIEH, M., TAI, C., TSAI, C., et al. (2001) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2001.00046.x · Cited by 50 · see citing works
Validation of Coronary Sinus Activation Pattern During Left Atrial Appendage Pacing for Beat‐to‐Beat Assessment of Mitral Isthmus Conduction/Block
Paisey, J., Betts, T. R., de Bono, J. P., et al. (2009) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2009.01638.x · Cited by 28 · see citing works
Radiofrequency ablation of atypical atrial flutter after cardiac surgery or atrial fibrillation ablation: a randomized comparison of open-irrigation-tip and 8-mm-tip catheters
Bai, R., Fahmy, T. S., Patel, D., Di Biase, L., Riedlbauchova, L., Wazni, O. M., Schweikert, R. A., Burkhardt, J. D., Saliba, W., & Natale, A. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.07.027 · Cited by 17 · see citing works
Mechanism of Regular Atrial Tachyarrhythmias During Combined Pulomonary Vein Isolation and Complex Fractionated Electrogram Ablation in Patients With Atrial Fibrillation
Nam, G., Jin, E., Choi, H., et al. (2010) · Circulation Journal · doi:10.1253/circj.cj-09-0622 · Cited by 14 · see citing works
How to ablate left atrial flutter
Shah, D. C., Sunthorn, H., Burri, H., & Gentil-Baron, P. (2005) · Heart Rhythm · doi:10.1016/j.hrthm.2005.04.028 · Cited by 6 · see citing works
Instantaneous Electrophysiological Changes Characterizing Achievement of Mitral Isthmus Linear Block
Miyazaki, S., Shah, A. J., Jadidi, A., SCHERR, D., Wilton, S. B., Hocini, M., Jaı̈s, P., & Haı̈ssaguerre, M. (2011) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2011.02107.x · Cited by 5 · see citing works
Left-Sided Atrial Flutter Originating in the Coronary Sinus after Radiofrequency Ablation of Atrial Fibrillation
Jiménez, A., Shorofsky, S. R., Dickfeld, T. M., et al. (2010) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2010.02718.x · Cited by 4 · see citing works

Flagged first, then by citations

Sorted by citations

European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)
Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
Self-citation
Atrial flutter: more than just one of a kind
Bun, S.-S., Latcu, D. G., Marchlinski, F., & Saoudi, N. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv118 · Cited by 115 · see citing works

Determinants ofrecurrentatrial flutterafter cardioversion
Pozen, R. G., Pastoriza, J., Rozanski, J. J., et al. (1983)
Clinical analysis of atrial flutter in children
唐浩勋, 袁越, 王利平, et al. (2008) · Zhongguo xiaoer jijiu yixue · doi:10.3760/cma.j.issn.1673-4912.2008.03.011
Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis
Pranata, R., Karwiky, G., & Iqbal, M. (2023) · Arrhythmia & Electrophysiology Review · doi:10.15420/aer.2023.19 · Cited by 13 · see citing works
Adjunct ablation strategies for persistent atrial fibrillation-beyond pulmonary vein isolation.
Magnani, S., Muser, D., CHIK, W. W. B., & Santangeli, P. (2015) · Europe PMC (PubMed Central) · doi:10.3978/j.issn.2072-1439.2015.01.25 · Cited by 11 · see citing works
Atrial flutter and atrial fibrillation ablation – sequential or combined? A cost-benefit and risk analysis of primary prevention pulmonary vein ablation
Gula, L. J., Skanes, A. C., Klein, G. J., Jenkyn, K. B., Redfearn, D., Manlucu, J., Roberts, J. D., Yee, R. K., TANG, A. S. L., & Leong‐Sit, P. (2016) · Heart Rhythm · doi:10.1016/j.hrthm.2016.02.018 · Cited by 21 · see citing works

Authors: BAI, R., BIASE, L. D., MOHANTY, P., RUSSO, A. D., CASELLA, M., PELARGONIO, G., THEMISTOCLAKIS, S., MOHANTY, S., ELAYI, C. S., SANCHEZ, J., BURKHARDT, J. D., HORTON, R., GALLINGHOUSE, G. J., BAILEY, S. M., BONSO, A., BEHEIRY, S., HONGO, R. H., RAVIELE, A., TONDO, C., & NATALE, A.
Affiliations: St David's Medical Center (US)
University of Milan (IT)
Università Cattolica del Sacro Cuore (IT)
University of Kentucky (US)
ORCID: BAI, RONG
BIASE, LUIGI DI
MOHANTY, PRASANT
RUSSO, ANTONIO DELLO
CASELLA, MICHELA
PELARGONIO, GEMMA
THEMISTOCLAKIS, SAKIS
MOHANTY, SANGHAMITRA
ELAYI, CLAUDE S.
BURKHARDT, J. DAVID
HORTON, RODNEY
GALLINGHOUSE, G. JOSEPH
HONGO, RICHARD H.
RAVIELE, ANTONIO
TONDO, CLAUDIO
NATALE, ANDREA
Venue: Journal of Cardiovascular Electrophysiology
Publisher: Wiley
Published: 2011-09-28
Volume: 23
Issue: 2
Pages: 137-144
ISSN: 1045-3873 (ISSN-L)
1540-8167
DOI: 10.1111/j.1540-8167.2011.02182.x
OpenAlex: W2089182054
Cited by: 50
References: 28
Citations by year: 2024: 2 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 10 · 2016: 2 · 2015: 9 · 2014: 3 · 2013: 4 · 2012: 6
FWCI: 3.08
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Cardiovascular Electrophysiology (publishedVersion)
PubMed (publishedVersion)
Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
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: perimitral flutter, atrial fibrillation, catheter ablation, pulmonary vein isolation, non-PV triggers, arrhythmia recurrence, long-standing persistent atrial fibrillation, cardioversion, antiarrhythmic drugs, arrhythmia-free survival
MeSH terms: Aged, Atrial Fibrillation, Atrial Flutter, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mitral Valve, Treatment Outcome, Catheter Ablation, Secondary Prevention

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 ›

Are you an author, or do you see a problem with this page? Request a review

Ablation of perimitral flutter following catheter ablation of atrial fibrillation: impact on outcomes from a randomized study (PROPOSE)

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks