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Risk of Atrial Fibrillation After Atrial Flutter Ablation: Impact of AF History, Gender, and Antiarrhythmic Drug Medication
Author(s) -
BREMBILLAPERROT BÉATRICE,
GIRERD NICOLAS,
SELLAL JEAN MARC,
OLIVIER ARNAUD,
MANENTI VLADIMIR,
VILLEMIN THIBAUT,
BEURRIER DANIEL,
CHILLOU CHRISTIAN,
LOUIS PIERRE,
SELTON OLIVIER,
CHAISE ARNAUD TERRIER
Publication year - 2014
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12413
Subject(s) - medicine , ablation , atrial fibrillation , atrial flutter , cardiology , amiodarone , catheter ablation , stroke (engine) , mechanical engineering , engineering
Antiarrhythmic Drug and Ablation of Atrial Flutter Introduction Atrial fibrillation (AF) and flutter (AFL) are frequently associated. We assessed the frequency and identified the predictors of AF occurrence after AFL ablation. Methods and Results A total of 1,121 patients referred for AFL ablation were followed for a mean duration of 2.1 ± 2.7 years. Antiarrhythmic drugs were stopped after ablation in patients with no AF prior to ablation, or continued otherwise. A total of 356 patients (31.7%) had a history of AF prior to AFL ablation. Patients with AF prior to ablation were more likely to be females (OR = 1.35, CI = 1.00–1.83, P = 0.05). After ablation, 260 (23.2%) patients experienced AF. In the multivariable model, AF prior to ablation (OR = 1.90, CI = 1.42–2.54, P < 0.001) and female gender (OR = 1.77, CI = 1.29–2.42, P < 0.001) were associated with a higher risk of AF after ablation. In patients without prior AF, class I antiarrhythmics and amiodarone prior to AFL ablation were independently associated with higher risk of AF after ablation (OR = 2.11, CI = 1.15–3.88, P = 0.02 and OR = 1.60, CI = 1.08–2.36, P = 0.02, respectively). In patients who experienced AF after ablation, 201/260 (77.3%) had a CHA2DS2‐VASc ≥1. Two patients with AF prior to ablation had a stroke during the follow‐up whereas none of the patients without AF prior to ablation had a stroke. Conclusions AF occurrence after AFL ablation is frequent (>20%), especially in patients with a history of AF, in female patients, and in patients treated with class I antiarrythmics/amiodarone prior to AFL. Since most patients who experience AF after AFL ablation have a CHA2DS2‐VASc ≥1, the decision to stop anticoagulants after ablation should be considered on an individual basis.