Effects of Cavotricuspid Isthmus Catheter Ablation on Paroxysmal Atrial Fibrillation

Kumagai, Koji; Tojo, Hideaki; Noguchi, Hiroo; Yasuda, Tomoo; Tamari, Hideki; Matsumoto, Naomichi; Gondo, Naoki; Nakashima, Hideko; Saku, Keijiro

doi:10.1536/jhj.42.79

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…This suggests that AFL may have been responsible for some episodes of AF. Consistent with a facilitatory role of typical AFL in the pathogenesis of AF, several prior studies have demonstrated that the incidence of AF may be lower after ablation of the cavo-tricuspid isthmus (17)(18)(19)(20). However, in none of these prior studies was the role of PV isolation assessed.…”

Section: Cavo-tricuspid Isthmus Ablation and Recurrence Of Afmentioning

confidence: 71%

Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation

Scharf

Veerareddy

Özaydın

et al. 2004

Journal of the American College of Cardiology

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Section: Cavo-tricuspid Isthmus Ablation and Recurrence Of Afmentioning

confidence: 71%

Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation

Scharf

Veerareddy

Özaydın

et al. 2004

Journal of the American College of Cardiology

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“…Typical atrial flutter also easily disorganizes into AF because atrial flutter with a short cycle length may transition to fibrillatory conduction (14). Therefore, CTI ablation may reduce AF recurrence by preventing the organization of AF into atrial flutter, which disrupts AF maintenance (5,(15)(16)(17). Finally, linear ablation of the CTI may have affected the right atrial ganglionated plexus.…”

Section: Mechanismsmentioning

confidence: 99%

Association of typical atrial flutter and cavotricuspid isthmus ablation on clinical recurrence after cryoballoon ablation for atrial fibrillation

Jeong,

Lee,

Choi

et al. 2023

Front. Cardiovasc. Med.

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Typical atrial flutter commonly occurs in patients with atrial fibrillation (AF). Limited information exists regarding the effects of concurrent atrial flutter on the long-term outcomes of rhythm control. This study investigated the association between concurrent typical atrial flutter and cavotricuspid isthmus (CTI) ablation and the recurrence of atrial arrhythmia. The data were obtained from a multicenter registry of cryoballoon ablation for AF (n = 2,689). Patients who were screened for typical atrial flutter were included in the analysis (n = 1,907). All the patients with typical atrial flutter underwent CTI ablation. The primary endpoint was the late recurrence of atrial arrhythmia, including AF, atrial flutter, and atrial tachycardia. Among the 1,907 patients, typical atrial flutter was detected in 493 patients (25.9%). Patients with concurrent atrial flutter had a lower incidence of persistent AF and a smaller size of the left atrium. Patients with atrial flutter had a significantly lower recurrence rate of atrial arrhythmia (19.7% vs. 29.9%, p < 0.001). In patients with atrial flutter, the recurrence rate of atrial tachycardia or atrial flutter was more frequent (7.3% vs. 4.7%, p = 0.028), but the recurrence rate of AF was significantly lower (17.0% vs. 29.4%, p < 0.001). Atrial flutter has been identified as an independent predictor of the primary endpoint (adjusted hazard ratio, 0.704; 95% confidence interval, 0.548–0.906; p = 0.006). Typical atrial flutter in patients with AF may serve as a positive marker of the recurrence of atrial arrhythmia, and performing CTI ablation in this population is associated with a reduced likelihood of AF recurrence. Performing routine screening and ablation procedures for coexisting atrial flutter may improve the clinical outcomes of AF.

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“…Several studies have reported that successful AFL ablation decreased the AF recurrence in 50-75% of patients with a history of AF (25)(26)(27)(28)(29)(30)(31)(32)(33). One meta-analysis also demonstrated that the recurrence of AF was 52.7% in patients which a history of AF after a mean of 16 months following period (34).…”

Section: Impact Of Afmentioning

confidence: 99%

Prediction of Recurrent Atrial Tachyarrhythmia After Receiving Atrial Flutter Ablation in Patients With Prior Cardiac Surgery for Valvular Heart Disease

Chou

Chung

Chang

et al. 2021

Front. Cardiovasc. Med.

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Background: Surgical scars cause an intra-atrial conduction delay and anatomical obstacles that facilitate the perpetuation of atrial flutter (AFL). This study aimed to investigate the outcome and predictor of recurrent atrial tachyarrhythmia after catheter ablation in patients with prior cardiac surgery for valvular heart disease (VHD) who presented with AFL.Methods: Seventy-two patients with prior cardiac surgery for VHD who underwent AFL ablation were included. The patients were categorized into a typical AFL group (n = 45) and an atypical AFL group (n = 27). The endpoint was the recurrence of atrial tachyarrhythmia during follow-up. A multivariate analysis was performed to determine the predictor of recurrence.Results: No significant difference was found in the recurrence rate of atrial tachyarrhythmia between the two groups. Patients with concomitant atrial fibrillation (AF) had a higher recurrence of typical AFL compared with those without AF (13 vs. 0%, P = 0.012). In subgroup analysis, typical AFL patients with concomitant AF had a higher incidence of recurrent atrial tachyarrhythmia than those without it (53 vs. 14%, P = 0.006). Regarding patients without AF, the typical AFL group had a lower recurrence rate of atrial tachyarrhythmia than the atypical AFL group (14 vs. 40%, P = 0.043). Multivariate analysis showed that chronic kidney disease (CKD) and left atrial diameter (LAD) were independent predictors of recurrence.Conclusions: In our study cohort, concomitant AF was associated with recurrence of atrial tachyarrhythmia. CKD and LAD independently predicted recurrence after AFL ablation in patients who have undergone cardiac surgery for VHD.

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Effects of Cavotricuspid Isthmus Catheter Ablation on Paroxysmal Atrial Fibrillation

Cited by 7 publications

References 25 publications

Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation

Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation

Association of typical atrial flutter and cavotricuspid isthmus ablation on clinical recurrence after cryoballoon ablation for atrial fibrillation

Prediction of Recurrent Atrial Tachyarrhythmia After Receiving Atrial Flutter Ablation in Patients With Prior Cardiac Surgery for Valvular Heart Disease

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