Atrial fibrillation after typical atrial flutter ablation: a long-term follow-up
Abstract
OBJECTIVE: Although catheter ablation is an effective treatment for typical atrial flutter (TFL), atrial fibrillation may occur during follow-up. The aim of this study was to assess the frequency of postablation atrial fibrillation in patients with or without atrial fibrillation before TFL ablation. METHODS: One hundred and ninety-two patients (135 men, age 68 ± 9 years) ablated for TFL were divided into two groups: group 1 (80 patients) with isolated TFL and group 2 (112 patients) with TFL and atrial fibrillation before ablation. The end-point of the study was the occurrence of documented atrial fibrillation after ablation. Several predetermined variables were tested with regard to atrial fibrillation occurrence. The patients' perception of the frequency and severity of arrhythmia-related symptoms was evaluated before and after ablation by means of the Symptom Checklist Frequency and Severity scale (SCFSS). RESULTS: At least one episode of atrial fibrillation was recorded in 18 (22.5%) group 1 and 52 (46%) group 2 patients (P = 0.001), during a follow-up of 1086 ± 825 and 1126 ± 962 days, respectively. On multivariate analysis, independent predictors of atrial fibrillation occurrence in group 1 were the number of preablation episodes of TFL and the younger age of the patients. The 37 group 2 patients who continued to have paroxysmal or persistent atrial fibrillation episodes after ablation showed a significant decrease in atrial fibrillation incidence and hospitalizations. SCFSS significantly improved in the 63 group 2 patients in whom it was evaluated. CONCLUSIONS: On long-term follow-up, after ablation of isolated TFL, more than three-quarters of patients remained free from atrial fibrillation. Conversely, in patients with preablation atrial fibrillation, TFL ablation reduced the number of atrial fibrillation episodes as well as the number of hospitalizations and arrhythmia-related symptoms.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
Isthmus ablation may also reduce AF recurrences in selected patients and help to prevent hospitalizations.
“It may also reduce AF recurrences in selected patients, 1003,1004 and help to prevent hospitalizations.1004,1005”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [1004]
Cites
Cappato, R., Calkins, H., Chen, S.-A., Davies, W., Iesaka, Y., Kalman, J., Kim, Y.-H., Klein, G., Natale, A., Packer, D., et al. (2010) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.109.859116 · Cited by 2,852 · see citing works
Natale, A., Newby, K. H., Pisanó, E., Leonelli, F., Fanelli, R., Potenza, D., Beheiry, S., & Tomassoni, G. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00635-5 · Cited by 414 · see citing works
Long-Term Outcomes After Catheter Ablation of Cavo-Tricuspid Isthmus Dependent Atrial Flutter
Pérez, F. J., Schubert, C. M., Parvez, B., Pathak, V., Ellenbogen, K. A., & Wood, M. A. (2009) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.109.871665 · Cited by 301 · see citing works
Bubien, R. S., Knotts-Dolson, S. M., Plumb, V. J., & Kay, G. N. (1996) · Circulation · doi:10.1161/01.cir.94.7.1585 · Cited by 284 · see citing works
Atrial flutter. I. Electrophysiologic substrates and modes of initiation and termination
Watson, R. M., & Josephson, M. E. (1980) · The American Journal of Cardiology · doi:10.1016/0002-9149(80)90115-0 · Cited by 187 · see citing works
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
TAI, C., CHEN, S., Chiang, C., Lee, S., Wen, Z., Huang, J., Chen, Y., Yu, W., EENG, A., LIN, Y., et al. (1998) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1998.tb00892.x · Cited by 166 · see citing works
The Risk of Atrial Fibrillation Following Radiofrequency Catheter Ablation of Atrial Flutter
Philippon, F., Plumb, V. J., Epstein, A. E., & Kay, G. N. (1995) · Circulation · doi:10.1161/01.cir.92.3.430 · Cited by 157 · see citing works
Atrial Fibrillation After Radiofrequency Ablation of Type I Atrial Flutter
Paydak, H., Kall, J. G., Burke, M. C., RUBENSTEIN, D. S., Kopp, D. E., Verdino, R. J., & Wilber, D. J. (1998) · Circulation · doi:10.1161/01.cir.98.4.315 · Cited by 155 · see citing works
Huang, D. T.-C., Monahan, K. M., ZIMETBAUM, P. J., PAPAGEORGIOU, P., MEpstein, L., & Josephson, M. E. (1998) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1998.tb01837.x · Cited by 153 · see citing works
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
Effect of Right Atrial Isthmus Ablation on the Occurrence of Atrial Fibrillation
Nabar, A., Rodriguez, L., Timmermans, C. C., van den Dool, A., Smeets, J. L. R. M., & Wellens, H. J. J. (1999) · Circulation · doi:10.1161/01.cir.99.11.1441 · Cited by 127 · see citing works
Radiofrequency Catheter Ablation of Common Atrial Flutter
Anselme, F., Saoudi, N. C., Poty, H., Douillet, R., & Cribier, A. G. (1999) · Circulation · doi:10.1161/01.cir.99.4.534 · Cited by 121 · 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
Atrial flutter in patients treated for atrial fibrillation with propafenone
Murdock, C. J., Kyles, A. E., Yeung-Lai-Wah, J. A., Qi, A., Vorderbrugge, S., & Kerr, C. R. (1990) · The American Journal of Cardiology · doi:10.1016/0002-9149(90)91144-u · Cited by 114 · see citing works
Schmieder, S. (2003) · European Heart Journal · doi:10.1016/s0195-668x(02)00846-1 · Cited by 101 · see citing works
HSIEH, M., TAI, C., Chiang, C., Tsai, C.-F., Yu, W., Chen, Y., Ding, Y.-A., & Chen, S. (2002) · Journal of Interventional Cardiac Electrophysiology · doi:10.1023/a:1021392105994 · Cited by 95 · see citing works
Bertaglia, E., Zoppo, F., Bonso, A., Proclemer, A., Verlato, R., Corò, L., Mantovan, R., D’Este, D., Zerbo, F., & Pascotto, P. (2004) · Heart · doi:10.1136/heart.90.1.59 · Cited by 88 · see citing works
Long‐Term Outcome of Patients After Successful Radiofrequency Ablation for Typical Atrial Flutter
GILLIGAN, D. M., Zakaib, J. S., FULLER, I. A., Shepard, R. K., DAN, D., Wood, M. A., Clemo, H. F., Stambler, B. S., & Ellenbogen, K. A. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.00150.x · Cited by 60 · see citing works
Moreira, W., Timmermans, C. C., Wellens, H. J. J., Mizusawa, Y., Philippens, S., Perez, D., & Rodriguez, L. (2007) · Circulation · doi:10.1161/circulationaha.107.711622 · Cited by 51 · see citing works
Atrial Flutter: Contemporary Electrophysiology and Catheter Ablation
Shah, D. C., Haı̈ssaguerre, M., Jaı̈s, P., TAKAHASHI, A., & Clémenty, J. (1999) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1999.tb00449.x · Cited by 46 · see citing works
Inter‐Relationships Between Atrial Flutter and Atrial Fibrillation
Waldo, A. L. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.t01-1-00236.x · Cited by 39 · see citing works
Symptomatic improvement after radiofrequency catheter ablation for typical atrial flutter
O’Callaghan, P. (2001) · Heart · doi:10.1136/heart.86.2.167 · Cited by 36 · see citing works
Incidence and predictive factors of atrial fibrillation after ablation of typical atrial flutter
Laurent, V., Fauchier, L., Pierre, B., Grimard, C., & Babuty, D. (2008) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-008-9323-1 · Cited by 24 · see citing works
Bottoni, N., Donateo, P., Quartieri, F., Tomasi, C., Oddone, D., Lolli, G., Menozzi, C., & Brignole, M. (2004) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2004.04.069 · Cited by 24 · see citing works
Costa, A. D., Romeyer-Bouchard, C., Zarqane-Sliman, N., Messier, M., Samuel, B., Kihel, A., Faure, E., & Isaaz, K. (2004) · Heart · doi:10.1136/hrt.2003.033308 · Cited by 16 · see citing works
Meißner, A., Christ, M., Maagh, P., Borchard, R., Bracht, M. V., Wickenbrock, I., Trappe, H., & Plehn, G. (2007) · Clinical Research in Cardiology · doi:10.1007/s00392-007-0559-z · Cited by 13 · see citing works
Delise, P., Sitta, N., Corò, L., Marras, E., Sciarra, L., Bocchino, M., & Berton, G. S. (2006) · Journal of Cardiovascular Medicine · doi:10.2459/01.jcm.0000250867.33036.fc · Cited by 13 · see citing works
Anné, W., Willems, R., Adriaenssens, B., ADAMS, J., Ector, H., & Heidbüchel, H. (2006) · Acta Cardiologica · doi:10.2143/ac.61.1.2005143 · Cited by 11 · see citing works
Ng, D. W. C., Altemose, G. T., Wu, Q. F., Srivathsan, K. S., & Scott, L. R. (2008) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)60892-6 · Cited by 10 · see citing works
Cade, S., Sedighian, S., Bortone, A. A., Gervasoni, R., Macia, J. C., Leclercq, F., Grolleau, R., & Pasquié, J. (2005) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P. F., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castellà, M., Diener, H., Heidbüchel, H., Hendriks, J., et al. (2016) · EP Europace · doi:10.1093/europace/euw295 · Cited by 6,438 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
2020 Clinical guidelines for Atrial fibrillation and atrial flutter
Arakelyan, M., Bockeria, L., Vasilieva, E., Golitsyn, S., Golukhova, E., Gorev, M., Davtyan, K., Drapkina, O., Kropacheva, E., Kuchinskaya, E. A., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4594 · Cited by 11 · see citing works
Voight, J. M., Akkaya, M., Somasundaram, P. E., Karim, R., Valliani, S., Kwon, Y., & Adabağ, S. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.06.038 · Cited by 64 · see citing works
Incidence of Atrial Fibrillation After Atrial Flutter Ablation
Maskoun, W., Pino, M. I., Ayoub, K. F., Llanos, O. L., Almomani, A. A., Nairooz, R. S., Hakeem, A., & Miller, J. M. (2016) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2016.03.014 · Cited by 58 · see citing works
Tomson, T. T., Kapa, S., Bala, R., Riley, M. P., Lin, D., Epstein, A. E., Deo, R., & Dixit, S. (2012) · Heart Rhythm · doi:10.1016/j.hrthm.2012.07.013 · Cited by 51 · see citing works
BREMBILLA‐PERROT, B., GIRERD, N., SELLAL, J. M., OLIVIER, A., MANENTI, V., VILLEMIN, T., BEURRIER, D., DE CHILLOU, C., LOUIS, P., SELTON, O., et al. (2014) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.12413 · Cited by 47 · see citing works
2025 Clinical practice guidelines for Atrial fibrillation and flutter
Golukhova, E., Golitsyn, S., Mikhailov, E., Revishvili, A., Arakelyan, M., Vasilyeva, E., Davtyan, K., Drapkina, O., Drozdova, L., Kropacheva, E., et al. (2026) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2025-6668 · Cited by 36 · see citing works
Giehm-Reese, M., Kronborg, M. B., Lukáč, P., Kristiansen, S. B., Nielsen, J. M., Johannessen, A. C., Jacobsen, P. K., Djurhuus, M. S., Riahi, S., HANSEN, P. S., et al. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2019.07.077 · Cited by 23 · see citing works
EURASIAN CLINICAL RECOMMENDATIONS ON DIAGNOSIS AND TREATMENT OF ATRIAL FIBRILLATION
Sp, G., Панченко, Е. П., Станиславовна, К. Е., Laiovich, L. I., Maykov, E. B., Mironov, N. Y., & Shakhmatova, O. O. (2019) · Eurasian heart journal · doi:10.38109/2225-1685-2019-4-4-85 · Cited by 21 · see citing works
Risk and Outcome after Ablation of Isthmus-Dependent Atrial Flutter in Elderly Patients
Brembilla-Perrot, B., Sellal, J., Olivier, A., Manenti, V., Villemin, T., Beurrier, D., de Chillou, C., Lamiral, Z., & Girerd, N. (2015) · PLoS ONE · doi:10.1371/journal.pone.0127672 · Cited by 18 · see citing works
Sex-related differences in peri- and post-ablation clinical data for patients with atrial flutter
Brembilla-Perrot, B., Huttin, O., Manenti, V., Benichou, M., Sellal, J., Zinzius, P. Y., Beurrier, D., Schwartz, J., Laporte, F., de Chillou, C., et al. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.12.088 · Cited by 10 · see citing works
Peng, G., Lin, A., Obeng-Gyimah, E. K., Hall, S. N., Yang, Y., Chen, S., Riley, M., Deo, R., Ali, A., Arkles, J., et al. (2021) · Heart Rhythm O2 · doi:10.1016/j.hroo.2021.04.003 · Cited by 9 · see citing works
Sp, G., Панченко, Е. П., Mironov, N. Y., Михайловна, Б. М., Gagloeva, D. A., Elfimova, E. M., Станиславовна, К. Е., Laiovich, L. I., Litvin, A. Y., Maykov, E. B., et al. (2025) · Eurasian heart journal · doi:10.38109/2225-1685-2025-3-6-77 · Cited by 8 · see citing works
Brembilla-Perrot, B., Olivier, A., Villemin, T., Vincent, J., Manenti, V., Beurrier, D., Chaise, A. T. D. L., Selton, O., Louis, P., de Chillou, C., et al. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.06.103 · Cited by 6 · see citing works
Vasudevan, A., Hundae, A., Borodge, D., McCullough, P. A., & WELLS, P. J. (2018) · Baylor University Medical Center Proceedings · doi:10.1080/08998280.2018.1464305 · Cited by 3 · see citing works
Сергіївна, Б. М., & Yabluchanskіy, M. I. (2018) · Zaporozhye Medical Journal · doi:10.14739/2310-1210.2018.3.132107
Clinical and structural risk factors predicting atrial fibrillation
Purmah, Y. (2020) · University of Birmingham Institutional Research Archive (University of Birmingham)
Khamnagadaev, I. A., Kovalev, I. A., Bulavina, I. A., Kokov, M. L., Zotov, A. S., Troitskiy, A. V., Khamnagadaev, I. I., Shkolnikova, M. A., & Сергеевич, К. Л. (2023) · Journal of clinical practice · doi:10.17816/clinpract114930
- Authors
- Bandini, A., Golia, P., Caroli, E., Biancoli, S., & Galvani, M.
- Affiliations
- Ospedale G.B. Morgagni - L.Pierantoni (IT)
- Corresponding author
- Bandini, Alberto
- Venue
- Journal of Cardiovascular Medicine
- Published
- 2011-02
- Volume
- 12
- Issue
- 2
- Pages
- 110-115
- ISSN
- 1558-2027 (ISSN-L)
- OpenAlex
- W2041100079
- Cited by
- 20
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2016: 5 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Medicine (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, typical atrial flutter, catheter ablation, hospitalization, predictors of atrial fibrillation, long-term follow-up
- MeSH terms
- Aged, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrial Flutter, Female, Follow-Up Studies, Humans, Italy, Male, Middle Aged, Patient Discharge, Patient Readmission, Recurrence, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Chi-Square Distribution, Proportional Hazards Models, Treatment Outcome, Catheter Ablation, Risk Assessment, Kaplan-Meier Estimate
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
