UNLABELLED: AF Ablation in Patients With Only Documentation of Atrial Flutter. OBJECTIVES: The aim of the study was to evaluate whether isolation of the pulmonary veins (PVs) at the time of cavotricuspid isthmus (CTI) ablation is beneficial in patients with lone atrial flutter (AFL). BACKGROUND: A high proportion of patients with lone persistent AFL have recurrent episodes of atrial fibrillation (AF) after CTI ablation. However, the benefit of AF ablation in patients with only documentation of AFL has not been determined. METHODS:Forty-eight patients with typical lone persistent AFL (age 56 ± 6; 90% male) were randomized to CTI ablation (Group A; n = 25) or to CTI + PV isolation (PVI) (Group B; n = 23). In addition to PVI, some patients in group B underwent ablation of complex fractionated electrograms and/or creation of left atrial roof and mitral isthmus ablation line in a stepwise approach when AF was induced and sustained for more than 2 minutes. Mean follow-up was 16 ± 4 months with a 48-hour ambulatory monitor every 2 months. RESULTS: There were no recurrences of AFL in either group. Six patients in group B (22%) underwent a stepwise ablation protocol. AF organized and terminated in 5 patients during ablation (83%). Complication rate was not significantly different among the groups. Twenty patients in group B (87%) and 11 patients in group A (44%) were free of arrhythmias on no medications at the end of follow-up (P < 0.05). CONCLUSIONS: Ablation of AF at the time of CTI ablation results in a significantly better long-term freedom from arrhythmias.
RCT Entities:
UNLABELLED: AF Ablation in Patients With Only Documentation of Atrial Flutter. OBJECTIVES: The aim of the study was to evaluate whether isolation of the pulmonary veins (PVs) at the time of cavotricuspid isthmus (CTI) ablation is beneficial in patients with lone atrial flutter (AFL). BACKGROUND: A high proportion of patients with lone persistent AFL have recurrent episodes of atrial fibrillation (AF) after CTI ablation. However, the benefit of AF ablation in patients with only documentation of AFL has not been determined. METHODS: Forty-eight patients with typical lone persistent AFL (age 56 ± 6; 90% male) were randomized to CTI ablation (Group A; n = 25) or to CTI + PV isolation (PVI) (Group B; n = 23). In addition to PVI, some patients in group B underwent ablation of complex fractionated electrograms and/or creation of left atrial roof and mitral isthmus ablation line in a stepwise approach when AF was induced and sustained for more than 2 minutes. Mean follow-up was 16 ± 4 months with a 48-hour ambulatory monitor every 2 months. RESULTS: There were no recurrences of AFL in either group. Six patients in group B (22%) underwent a stepwise ablation protocol. AF organized and terminated in 5 patients during ablation (83%). Complication rate was not significantly different among the groups. Twenty patients in group B (87%) and 11 patients in group A (44%) were free of arrhythmias on no medications at the end of follow-up (P < 0.05). CONCLUSIONS: Ablation of AF at the time of CTI ablation results in a significantly better long-term freedom from arrhythmias.
Authors: Jorge Romero; Juan Carlos Diaz; Luigi Di Biase; Saurabh Kumar; David Briceno; Usha B Tedrow; Carolina R Valencia; Samuel H Baldinger; Bruce Koplan; Laurence M Epstein; Roy John; Gregory F Michaud; William G Stevenson Journal: J Interv Card Electrophysiol Date: 2017-01-09 Impact factor: 1.900
Authors: Justyna Rzucidlo; Priya Panday; Marissa Lombardo; Eric H Shulman; David S Park; Scott A Bernstein; Lior Jankelson; Douglas Holmes; Anthony Aizer; Larry A Chinitz; Chirag R Barbhaiya Journal: J Atr Fibrillation Date: 2021-06-30
Authors: Samuel Stempfel; Stefanie Aeschbacher; Steffen Blum; Pascal Meyre; Rebecca Gugganig; Jürg H Beer; Richard Kobza; Michael Kühne; Giorgio Moschovitis; Gianluca Menghini; Jan Novak; Stefan Osswald; Nicolas Rodondi; Elisavet Moutzouri; Matthias Schwenkglenks; Fabienne Witassek; David Conen; Christian Sticherling Journal: Int J Cardiol Heart Vasc Date: 2020-06-16
Authors: Dan L Musat; Nicolle S Milstein; Jacqueline Pimienta; Advay Bhatt; Mark W Preminger; Tina C Sichrovsky; Laura Flynn; Carissa Pistilli; Richard E Shaw; Suneet Mittal Journal: Cardiovasc Digit Health J Date: 2020-10-29