Late recurrent arrhythmias after ablation of atrial fibrillation: incidence, mechanisms, and treatment.

Kobza, Richard; Hindricks, Gerhard; Tanner, Hildegard; Schirdewahn, Petra; Dorszewski, Anja; Piorkowski, Christopher; Gerds-Li, Jin-Hong; Kottkamp, Hans (2004). Late recurrent arrhythmias after ablation of atrial fibrillation: incidence, mechanisms, and treatment. Heart rhythm, 1(6), pp. 676-683. Elsevier 10.1016/j.hrthm.2004.08.009

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OBJECTIVES

The aim of the study was to determine the incidence of atrial flutter and other arrhythmia recurrences (other than atrial fibrillation [AF]) during long-term follow-up after left atrial substrate modification by percutaneous radiofrequency (RF) ablation of AF.

BACKGROUND

RF ablation is an effective treatment for patients with AF. However, late recurrent arrhythmias may complicate the patient's course.

METHODS

One hundred fifty consecutive patients with paroxysmal or persistent AF were included in this prospective study. The incidence of arrhythmia recurrences after AF ablation was analyzed during long-term follow-up using repetitive 7-day ECG recording.

RESULTS

In 28 of 150 patients (18.7%), stable regular arrhythmias other than AF were detected during follow-up. Left atrial flutter observed in 10 patients (6.7%) was treated by recompletion of the ablation lines in all 10 patients. Left atrial flutter was associated with recurrence of AF in all 10 patients. Nine of 10 patients (90%) were free from atrial flutter and 6 of 10 patients were free from AF after the second intervention. Typical right atrial flutter occurred in 10 patients (6.7%) and was treated successfully by percutaneous RF ablation without recurrence in all patients. Additionally, atrial flutter was documented during follow-up in 7 patients (4.7%); however, invasive electrophysiologic evaluation was not performed due to various reasons.

CONCLUSIONS

Left atrial flutter is a relevant complication after RF catheter ablation of AF and was always associated with AF recurrence in our study population. Prevention of left atrial flutter can be achieved by induction of ablation lines as continuous and transmural as possible. However, left atrial flutter that does occur late after ablation is amenable to interventional treatment with good prospects of success.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Tanner, Hildegard
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1547-5271
Publisher:	Elsevier
Language:	English
Submitter:	Hildegard Tanner
Date Deposited:	20 Jun 2014 16:09
Last Modified:	05 Dec 2022 14:28
Publisher DOI:	10.1016/j.hrthm.2004.08.009
PubMed ID:	15851239
URI:	https://boris.unibe.ch/id/eprint/42317