Atrial fibrillation after typical atrial flutter ablation: a long-term follow-up

Abstract

Feasibility and clinical usefulness of high resolution sound map with cross plane method for AF ablation Yeong-Hwa CHUN (Eiwa Zen) (Japan) i1 OP 16-2 Robotic navigation for catheter ablation of atrial fibrillation-is there a learning curve? Fahd CHAHADI (Australia) i1 OP 16-3 Effect of atrial fibrillation on catheter-tissue contact during antral pulmonary vein isolation in humans: lower contact force at the left anterior pulmonary vein in atrial fibrillation compared to sinus or paced rhythm Saurabh KUMAR (Australia) i1 OP 16-4 First human validation of a new epicardial access needle with a real time pressure monitoring to facilitate epicardial access Luigi DI BIASE (United States of America) i1 OP 16-5 Endoscopic ablation by unilateral approach (left chest) for lone atrial fibrillation: a single center experience in 100 consecutive patients Ju MEI (China) ix OP 16-6 Exploring the relationship between contact force and clinical outcomes between human and robot-assisted AF ablation: early results of MAST-AF Gavin S CHU (United Kingdom) i2 AFL ABLATION OP 14-1 Effect of respiration on catheter movement and stability during cavotricuspid isthmus ablation for atrial flutter Saurabh KUMAR (Australia) i3 OP 14-2 Electroanatomic characterization and ablation outcome of nonlesion related left atrial macroreentrant tachycardiain patients without obvious structural heart disease Jinlin ZHANG (China) Pouch depth is the sole factor affecting the radiofrequency duration and energy for right atrial cavotricuspid isthmus catheter ablation Kazuto KUJIRA (Japan) i4 ALTERNATIVE SITE PACING OP 22-1 Getting RV lead at thinner part of interventricular septum tends to shorten paced QRS duration with less dyssynchrony Dmytro VOLKOV (Ukraine) i5 OP 22-2 Is right ventricular outflow tract (RVOT) septal pacing better than right ventricular apical (RVA) septal pacing with regard to long term left ventricular function and mechanical synchrony? Gaurav GANESHWALA (India) i5

Risk of Atrial Fibrillation After Atrial Flutter Ablation: Impact of AF History, Gender, and Antiarrhythmic Drug Medication

“…We found, as in previous studies, that AF history was a strong predictor of AF occurrence after AFL ablation, with an almost 2‐fold increase in the risk of subsequent AF in patients with AF history prior to ablation. This finding is in contradiction with the hybrid therapy concept put forward in the late 1990s and early 2000s, in order to reduce the risk of AF recurrences .…”

“…This finding is in contradiction with the hybrid therapy concept put forward in the late 1990s and early 2000s, in order to reduce the risk of AF recurrences . However, several studies have shown that the risk of AF recurrence in patients with a history of AF was elevated, reaching as high as 70% at 3 years . Our results confirm the limited impact of hybrid therapy on the long‐term control of AF.…”

“…There are many published reports focusing on the factors associated with AF occurrence during or after the ablation of AFL in patients with and without clinical history of AF . Indeed, 26% to 46% of patients are likely to develop AF with a clinical, ECG‐, or Holter‐based diagnosis strategy . Implantable loop recorder data even suggest that more than 50% of patients suffer from new‐onset AF after AFL ablation …”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Ablacja cieśni trójdzielno-żylnej w przypadku trzepotania z prawego przedsionka zależnego od cieśni trójdzielno-żylnej (albo częste trzepotanie z krążeniem pobudzenia w kierunku przeciwnym do ruchu wskazówek zegara, albo rzadsze trzepotanie z krążeniem pobudzenia w kierunku zgodnym z ruchem wskazówek zegara) umożliwia przywrócenie i utrzymanie rytmu zatokowego w 90-95% przypadków [1002]. Takie leczenie może również ograniczyć występo-wanie nawrotów AF u wybranych pacjentów [1003,1004], a także ułatwić zapobieganie hospitalizacjom [1004,1005]. Ablacja cieśni trójdzielno-żylnej jest podobnie bezpieczna jak farmakoterapia antyarytmiczna, natomiast jest od niej bardziej skuteczna i zaleca się ją jako leczenie nawracającego trzepotania przedsionków [585][586][587]713].…”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Ablation of the cavotricuspid isthmus for isthmus-dependent right atrial flutter (either the common counter-clockwise atrial flutter or the less-common clockwise atrial flutter) restores and maintains sinus rhythm with a success rate of 90-95%. 1002 It may also reduce AF recurrences in selected patients, 1003,1004 and help to prevent hospitalizations. 1004,1005 Isthmus ablation is comparably safe and more effective than antiarrhythmic drug therapy, and is recommended for recurrent atrial flutter.…”