Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: long-term follow-up.

Abstract

BACKGROUND:

The aim of the study was identification of the predictors of left atrial tachycardia and left atrial flutter (LATAFL) after radiofrequency catheter ablation of atrial fibrillation (CAAF).

METHODS:

We followed 598 patients (71% male, 41% paroxysmal AF; median follow-up: 36 months) after a single step-wise CAAF procedure. The time to first documented LATAFL lasting longer than 30 s, documented in any kind of electrocardiography (ECG), was defined as an end-point.

RESULTS:

A single CAAF procedure resulted in LATAF in 58 (10%) patients. Additional lesions were performed in 275 (46%) patients. Early LATAFL recurrence (£ 3 months since the index procedure) was observed in 11 (2%) patients. Late LATAFL (> 3 months) was noted in 47 (8%) patients. The univariate predictors of LATAFL recurrence were: type of AF (p = 0.003), the size of LA (p = 0.002) and the type of procedure (p = 0.0001). The identified single independent predictors of LATAFL recurrence were enlarged LA (p = 0.001) and mul-tiple (≥ 2) additional lesions performed during the index procedure (p < 0.0001).

CONCLUSIONS:

Higher rate of LATAFL recurrence was observed in patients with non-paroxysmal AF, enlarged LA and any additional lesions performed. Two independent predictors of LATAFL recurrence after CAAF were: the enlarged LA and multiple (≥ 2) additional lesions performed during the index procedure.

• Authors: Maciej Wójcik, Alexander Berkowitsch, Sergey Zaltsberg, Christian W Hamm, Heinz F Pitschner, Malte Kuniss, Thomas Neumann
• Journal: Cardiology journal (Cardiol J) Vol. 22 Issue 5 Pg. 557-66 ( 2015) ISSN: 1898-018X [Electronic] Poland
• PMID: 26202652 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Atrial Fibrillation (diagnosis, physiopathology, surgery)
• Atrial Flutter (diagnosis, etiology, physiopathology)
• Catheter Ablation (adverse effects)
• Disease-Free Survival
• Electrocardiography
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Recurrence
• Risk Assessment
• Risk Factors
• Tachycardia, Supraventricular (diagnosis, etiology, physiopathology)
• Time Factors
• Treatment Outcome