Key result
A significant proportion of patients undergoing cavo-tricuspid isthmus ablation for typical atrial flutter develop subsequent atrial fibrillation, particularly those with a prior history of AF.
A significant proportion of patients undergoing CTI ablation for typical atrial flutter develop AF, suggesting that combined PV isolation and flutter ablation may be an effective strategy for those with documentation of both arrhythmias.
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May support combined PVI-CTI ablation in patients with both arrhythmias; hypothesis-generating and requires randomized confirmation.
Typical atrial flutter (AFL) or type I AFL is the most common type of macroreentrant atrial tachycardia. Its prevalence increases with age and is more common in men. Ablation of the cavo-tricuspid isthmus (CTI), a critical part of the circuit, is safe and highly effective. Despite the long-term efficacy of this therapy, a significant proportion of patients undergoing CTI ablation will develop atrial fibrillation (AF) during the follow-up and identifying them can have an important impact on their management. PV isolation and typical flutter ablation during the same procedure may be an effective treatment strategy for patients with clinical documentation of both arrhythmias.
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Park et al. (2013) conducted a review in Atrial Flutter and Atrial Fibrillation. Cavo-tricuspid isthmus (CTI) ablation was evaluated on Occurrence of atrial fibrillation after typical atrial flutter ablation. A significant proportion of patients undergoing cavo-tricuspid isthmus ablation for typical atrial flutter develop subsequent atrial fibrillation, particularly those with a prior history of AF.
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