Atrial Fibrillation And Its Determinants After Radiofrequency Ablation Of Chronic Common Atrial Flutter

Objective:Atrial fibrillation (AFib) is a major clinical issue and its occurrence is the main problem after catheter ablation of atrial flutter. the aim of our study was to analyze the determinants and the time course of AFib after radiofrequency catheter ablation of chronic common atrial flutter.Methods:92consecutive patients (70 male and 22 female patients; mean age 47.5±13.0 years) underwent RF ablation of chronic common atrial flutter. None of them had AFL induced by Ic antiarrhythmic treatment. 41.3 % had previous history of paroxysmal AFib. 70% had no underlying structural heart disease. The aim of the ablation was termination of AFL with restoration of sinus rhythm associated to bidirectional block in the cavo-tricuspid isthmus as commonly described.Results:Over a mean follow-up of 38±13 months, the occurrence rate of AFib progressively increased up to 31.1% at the end of follow-up. The median occurrence time for AFib was 8 months. AFib occurrence was significantly associated with previous AFib history (P<0.05) but not with the presence of underlying heart disease. Palpitations after chronic common atrial flutter ablation was mostly related to AFib.Conclusion. In conclusion, after chronic common atrial flutter ablation, AFib incidence progressively increased over the follow-up in all patients. Patients with prior AFib history appeared to be a very high risk group. In these patients, closer monitoring is mandatory and the persistent risk of AFib recurrences may justify prolonged anticoagulation policy.