Catheter ablation of typical atrial flutter improves cardiac chamber size and function

Introduction Cavo‐tricuspid isthmus (CTI) dependent atrial flutter (AFL) is one of the most common atrial arrhythmias involving the right atrium (RA) for which radiofrequency catheter ablation has been widely used as a therapy of choice. However, there is limited data on the effect of this intervention on cardiac size and function. Methods A retrospective study was conducted on 468 patients who underwent ablation for CTI dependent typical AFL at a single institution between 2010 and 2019. After excluding patients with congenital or rheumatic heart disease, heart transplant recipients, or those without baseline echocardiogram, a total of 130 patients were included in the analysis. Echocardiographic data were analyzed at baseline before ablation, and at early follow‐up within 1‐year postablation. Follow‐up echocardiographic data was available for 55 patients. Results Of the 55 patients with CTI‐AFL, the mean age was 64.2 ± 14.8 years old with 14.5% ( n = 8) female. The average left ventricular ejection fraction (LVEF) significantly improved on follow‐up echo (40.2 ± 16.9 to 50.4 ± 14.9%, p < .0001), of which 50% of patients had an improvement in LVEF of at least 10%. There was a significant reduction in left atrial volume index (82.74 ± 28.5 to 72.96 ± 28 mL/m 2 , p = .008) and RA volume index (70.62 ± 25.6 to 64.15 ± 31 mL/m 2 , p = .046), and a significant improvement in left atrial reservoir strain (13.04 ± 6.8 to 19.10 ± 7.7, p < .0001). Conclusions Patients who underwent CTI dependent AFL ablation showed an improvement in cardiac size and function at follow‐up evaluation. While long‐term results are still unknown, these findings indicate that restoration of sinus rhythm in patients with typical AFL is associated with improvement in atrial size and left ventricular function.