Severe Left Ventricular Systolic Dysfunction Increases Atrial Fibrillation After Ablation of Atrial Flutter

Zambito, Peter E.; Talreja, Ashok; Gundewar, Susheel; Fisher, John D.; Ferrick, Kevin J.; Gross, Jay N.; Kim, Soo Jeong; Palma, Eugen C.

doi:10.1111/j.1540-8159.2005.00223.x

Cited by 6 publications

(3 citation statements)

References 21 publications

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“…Ideally, patients with a higher baseline risk for developing newly diagnosed AF after cAFL ablation should be identified by risk factors, in order to direct resources for a more intense follow-up of these patients. Although some prior studies have identified such risk factors, including age [13], left ventricular dysfunction [1,14,15], left atrial dilatation [2,16] and arterial hypertension [1], these were not consistent across studies [17]. In our study, we only identified coronary artery disease as a significant predictor for recurrent AF or AT.…”

Section: Discussioncontrasting

confidence: 67%

Prospective Evaluation of a Standardized Screening for Atrial Fibrillation after Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

Krisai

Roten

Zeljković

et al. 2021

JCM

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Aims: We aimed to prospectively investigate the effectiveness of a standardized follow-up for AF-detection after common atrial flutter (cAFL) ablation. Methods: A total of 309 patients after cAFL ablation without known AF, from 5 centers, and at least one completed, standardized follow-up at 3, 6 and 12 months, including a 24 h Holter-electrocardiogram (ECG), were included. The primary outcome was incident atrial fibrillation (AF), or atrial tachycardia (AT). Predictors were investigated by Cox proportional-hazards models. Results: The mean age was 67.9 years; 15.2% were female and the mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age, Diabetes, Stroke, Vascular disease, Sex category) score was 2.4 points. The great majority of patients (90.3%) were anticoagulated. Over a mean follow-up of 12.2 months with a standardized approach, AF/AT was detected in 73 patients, corresponding to 11.7% at 3 months, 18.4% at 6 months and 28.2% at 12 months of follow-up. AF was found in 64 patients, AT in 9 and both in 2 patients. Occurrence of AF was recorded in 40 (60.6%) patients by Holter-ECG and in the remaining 26 (39.4%) by clinical follow-up only. There was no difference in male versus female (p = 0.08), or in younger versus older patients (p = 0.96) for AF/AT detection. Only coronary artery disease (hazard ratio [95% confidence intervals] 1.03 [1.01–1.05], p = 0.01) was associated with the primary outcome. Conclusions: AF or AT was detected in a large proportion of cAFL patients after cavotricuspid-isthmus (CTI) ablation, using a standardized follow-up over 1 year. This standardized screening can be easily implemented with high patient acceptance. The high proportion of post-ablation AF needs to be taken into consideration when deciding on long-term oral anticoagulation.

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Section: Discussioncontrasting

confidence: 67%

Prospective Evaluation of a Standardized Screening for Atrial Fibrillation after Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

Krisai

Roten

Zeljković

et al. 2021

JCM

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“…Informed consent was obtained from all patients. As described previously, 12 a 20‐pole catheter, with regular 2–10 mm spacing (Duo‐Dec Super Lrg Curl, Daig Corp., Minnetonka, MN, USA) was placed with the distal tip in the mid‐coronary sinus, spanning the isthmus, and with the proximal part in the high right atrium (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

DP+1: Another Simple Endpoint for Atrial Flutter Ablation

Zambito

Palma

2007

Cardiovasc electrophysiol

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DP+1. Background: When double potentials (DP) on the line of block are difficult to see, we propose another simple method to verify complete bidirectional block (CBDB) at the end of an atrial flutter ablation. We measured the interval between the electrograms immediately on either side of the line of block on a multipole catheter spanning the isthmus. We called this interval "DP+1" because it is one pair of electrodes away from the DP on the line of block.Methods: Fifty consecutive patients (age 62 ± 13 years, LVEF 54 ± 11%, mean cycle length 241 ± 34 ms) underwent an atrial flutter ablation using a duodecapolar catheter with 2-10 mm spacing with the distal tip inserted into the mid-coronary sinus and the rest of the poles spanning the isthmus and the low lateral right atrium. Radiofrequency ablation was performed using a 10-mm tip electrode (EP Technologies). The ablation endpoint was the creation of a craniocaudal activation pattern of the opposite wall to the pacing site (septal and lateral of the line of block).Results: The ablation endpoint was achieved in 48 of 50 (96%) patients with 8 ± 2 RF applications. Adequate DP were found in only 22 of 50 patients (44%), but the DP+1 interval was measurable in all patients. When no block was present, the DP+1 interval was 81 ± 10 ms, and 160 ± 18 ms when complete bidirectional block was present (P < 0.001). A DP+1 interval of >140 ms had 100% specificity, 96% sensitivity, 100% positive predictive value for verifying complete bidirectional block. After a follow-up of 528 ± 253 days, there were no recurrences of AFL, but there were four recurrences of AF (8%).Conclusion: When DP cannot be seen, another simple method for verifying CBDB in ablation of typical atrial flutter is a DP+1 interval >

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“…Stellate Ganglion Block (SGB), a cervical sympathetic blockade, has been widely used to treat some refractory arrhythmia storms. 12 , 13 Studies have shown that blocking or resecting the stellate ganglion can inhibit the occurrence and maintenance of Atrial Fibrillation (AF), possibly by regulating the autonomic and immune systems. 7 , 14 However, the reported changes in cardiac function with LSGB in the literature have been contradictory.…”

Section: Introductionmentioning

confidence: 99%

Effect of ultrasound-guided right stellate ganglion block on perioperative atrial fibrillation in patients undergoing lung lobectomy: a randomized controlled trial

Ouyang

et al. 2020

Brazilian Journal of Anesthesiology (English Edition)

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Severe Left Ventricular Systolic Dysfunction Increases Atrial Fibrillation After Ablation of Atrial Flutter

Cited by 6 publications

References 21 publications

Prospective Evaluation of a Standardized Screening for Atrial Fibrillation after Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

Prospective Evaluation of a Standardized Screening for Atrial Fibrillation after Ablation of Cavotricuspid Isthmus Dependent Atrial Flutter

DP+1: Another Simple Endpoint for Atrial Flutter Ablation

Effect of ultrasound-guided right stellate ganglion block on perioperative atrial fibrillation in patients undergoing lung lobectomy: a randomized controlled trial

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