TY - JOUR
T1 - Atrial fibrillation inducibility during cavo-tricuspid isthmus dependent atrial flutter ablation for the prediction of clinical atrial fibrillation
AU - Romero, Jorge
AU - Estrada, Rodolfo
AU - Holmes, Anthony
AU - Goodman-Meza, David
AU - Diaz, Juan Carlos
AU - Briceño, David
AU - Kumar, Saurabh
AU - Baldinger, Samuel H.
AU - Valencia, Carolina R.
AU - Roth, Norman
AU - Fisher, John D.
AU - Gross, Jay
AU - Krumerman, Andrew
AU - Ferrick, Kevin
AU - Kim, Soo
AU - Piña, Ileana L.
AU - Garcia, Mario
AU - Di Biase, Luigi
N1 - Publisher Copyright:
© 2017
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background Atrial fibrillation (AF) and cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. Methods We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow up after AFL ablation. Univariate and multivariate analyses were performed. Results A total of 154 patients (male: 72%, age: 61 ± 13) with AFL and without history of AF were included. All patients underwent successful CTI dependent AFL ablation demonstrated by bidirectional block. During ablation, AF was seen or induced in 28 (18%) patients. After a mean follow up of 34 ± 24 months a total of 50 patients (32%) were noted with clinically manifest AF. From the patients who had inducible AF during AFL ablation, 50% developed post-procedural AF. From those in whom AF could not be induced, only 29% were documented with AF after ablation. Univariate and multivariate analyses revealed that only age and AF inducibility during AFL ablation were predictors of AF. Univariate analysis (age p = 0.038 and inducible AF p = 0.032 with odds ratio of 1.030 [95% CI (1.002–1.059)] and 2.500 [95% CI (1.084–5.765)], respectively) and multivariate analyses (age p = 0.011 and inducible AF p = 0.016 with adjusted odds ratio of 1.043 [95% CI (1.010–1.077)] and 3.293 [95% CI (1.250–8.676)], respectively). Conclusion AF inducibility in patients undergoing CTI AFL without history of AF is a strong predictor of AF occurrence in the future. Appropriate cardiology follow-up must be encouraged in this high-risk population as stroke prevention strategies can be appropriately introduced in a timely matter especially in patients with elevated CHA2DS2-VASc scores (≥ 2).
AB - Background Atrial fibrillation (AF) and cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. Methods We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow up after AFL ablation. Univariate and multivariate analyses were performed. Results A total of 154 patients (male: 72%, age: 61 ± 13) with AFL and without history of AF were included. All patients underwent successful CTI dependent AFL ablation demonstrated by bidirectional block. During ablation, AF was seen or induced in 28 (18%) patients. After a mean follow up of 34 ± 24 months a total of 50 patients (32%) were noted with clinically manifest AF. From the patients who had inducible AF during AFL ablation, 50% developed post-procedural AF. From those in whom AF could not be induced, only 29% were documented with AF after ablation. Univariate and multivariate analyses revealed that only age and AF inducibility during AFL ablation were predictors of AF. Univariate analysis (age p = 0.038 and inducible AF p = 0.032 with odds ratio of 1.030 [95% CI (1.002–1.059)] and 2.500 [95% CI (1.084–5.765)], respectively) and multivariate analyses (age p = 0.011 and inducible AF p = 0.016 with adjusted odds ratio of 1.043 [95% CI (1.010–1.077)] and 3.293 [95% CI (1.250–8.676)], respectively). Conclusion AF inducibility in patients undergoing CTI AFL without history of AF is a strong predictor of AF occurrence in the future. Appropriate cardiology follow-up must be encouraged in this high-risk population as stroke prevention strategies can be appropriately introduced in a timely matter especially in patients with elevated CHA2DS2-VASc scores (≥ 2).
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U2 - 10.1016/j.ijcard.2017.01.131
DO - 10.1016/j.ijcard.2017.01.131
M3 - Article
C2 - 28606678
AN - SCOPUS:85020450852
SN - 0167-5273
VL - 240
SP - 246
EP - 250
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -