0362: Atrial fibrillation after radiofrequency ablation of atrial flutter: prevalence and risk factors - 12/02/16
, François Lesaffre, Pierre Nazeyrollas, Karine Bauley, Jean-Pierre Chabert, Leïla Simone, Huu Tri Bui, Anthony Foulon, Bertrand Girodet, Julien Voyez, Damien MetzBienvenue sur EM-consulte, la référence des professionnels de santé.
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Résumé |
Background |
Radiofrequency ablation (RFA) is the only curative treatment for typical atrial flutter (AFL) and allows stopping antiarrhythmic drugs. However, atrial fibrillation (AF) is frequent during follow-up but predictive factors of AF onset are unknown while it is necessary to diagnose it in order to apply the correct antithrombotic strategy.
Aims |
To determine prevalence and predictors of AF after AFL RFAAFL.
Methods |
From January 2012 to December 2013, patients who underwent RFA of cavotricuspid isthmus for typical atrial flutter in our centre were retrospectively included.
Results |
Of 166 patients (137 men, mean age: 66.7±10 years), 61 (36.7%) had a history of AF.
The mean CHA2DS2VASc and HASBLED scores were 2.49 and 1.11. Mean left ventricular ejection fraction was 53±13% and 77 (46.4%) patients had a subsequent cardiomyopathy, whereas 61 (36.7%) had a history of AF. Of 166 RFA, sinus rhythm was obtain in 160 patients and 141 (84.9%) procedures were considered as a complete success (complete isthmus block). During a mean follow up of 489±244 days, there were 7 (5%) and 9 (36%) AFL recurrence in patients with and without isthmus block respectively. New-onset or recurrent AF were experienced by 63 (39%) patients.
History of AF was an independent predictive factor of AF (33 (52.4%) vs. 28 (27.2%) patients; p=0.002).
The younger patients (64.4±11.7 vs. 68.2±9.9 years; p=0.03) and patients with lower CHA2DS2VASc score had more AF post ablation (2.16±1.53 vs. 2.70±1.57; p=0.03).
Conclusion |
After successful RF ablation, AF was frequent in patients especially in patient with AF history before AFL RFA, but also occurred in patient with lone AFL. Age and CHA2DS2VASc score were inversely associated with onset of AF. Identify AF and risk patients is crucial regarding to long-term antithrombotic therapy.
Abstract 0362 – Table: predictive factors of AFNo FA post ablation(N=103)FA post ablation (N=63)pMen/Women (N/N)89/1448/150.09Age (years)68.2+/–9.964.4+/–11.70.03*SAS10 (9.7)4 (6.3)0.57Cardiopathy53 (51.5)24 (38.1)0.11History of AF (N [%])28 (27.2)33 (52.4)0.002*Dilated LA (N [%])43 (41.7)32 (50.8)0.4Dilated LV (N [%])12 (11.7)12 (19)0.41LVEF<45% (N [%])29 (28.2)10 (15.9)0.09High blood pressure (N [%])63 (61.2)31 (49.2)0.14Age≥75 years29 (28.2)15 (23.8)0.59Diabetes mellitus18 (17.5)9 (14.3)0.66CHA2DS2VASc2.7+/–1.572.16+/–1.530.03*BMI (kg/m2)27.4+/–5.527.9+/–4.90.55Creatinine clearance (Cockroft)78.1+/–30.885.3+/–37.40.19Creatinine clearance (MDRD)72.8+/–22.473.9+/–23.70.76SAS: sleep apnoea syndrome; AF: atrial fibrillation; LA: left atrial; LV: left ventricular LVEF: left ventricular ejection fraction; BMI: body mass index
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| SAS: sleep apnoea syndrome; AF: atrial fibrillation; LA: left atrial; LV: left ventricular LVEF: left ventricular ejection fraction; BMI: body mass index |
Plan
Vol 8 - N° 1
P. 69-70 - janvier 2016 Retour au numéro
Article précédent
- 0218: Influence of gender on the distribution of anatomic anomalies of the pulmonary veins (PVs) in a cohort of 38 patients with atrial fibrillation (AF)
- Lobna Laroussi, Afef Ben Halima, Emna Bouzgarrou, Zied Ibn El Haj, Haytham Raddaoui, Ahmed Houmed, Faouzi Addad, Asma Zidi, Salem Kachboura
- 0435: Anesthesia in ablation procedures is differently proposed in public and private centers. The French Electra survey
- Jerome Taieb, Frederic Georger, Jacques Mansourati, Frederic Fossati, Arnaud Lazarus, Jean-Pierre Cebron, Maxime Guenoun
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