Key result
Left atrial volume index ≥ 30 ml/m2 was independently associated with a increased risk of incident atrial fibrillation following cavotricuspid isthmus ablation for typical atrial flutter.
Why the study?
Incident AF is common after CTI-dependent AFL ablation, but risk factors for the development of post-ablation AF are not well understood.
Does elevated Left Atrial Volume Index predict incident atrial fibrillation in patients undergoing CTI ablation for typical atrial flutter?
Cohort (n=114)
No
Does elevated Left Atrial Volume Index predict incident atrial fibrillation in patients undergoing CTI ablation for typical atrial flutter?
Elevated left atrial volume index is an independent predictor of incident atrial fibrillation following cavotricuspid isthmus ablation for typical atrial flutter.
Answers are grounded in this paper and cite their sources.
May inform post-ablation risk stratification in typical atrial flutter; leaves open whether left atrial volume index modification prevents incident AF.
PURPOSE: Incident atrial fibrillation (AF) is common after cavotricuspid isthmus (CTI) dependent atrial flutter (AFL) ablation. Risk factors for the development of AF post ablation are not well understood. The purpose of this study was to identify patients undergoing CTI ablation for AFL most likely to develop AF. METHODS: Retrospective chart review identified 114 consecutive patients without a history of AF or prior cardiac surgery who underwent typical CTI dependent AFL ablation between December 2013 to November 2018, who also had a complete preoperative transthoracic echocardiogram, and at least 1 year of follow-up at our medical center. We evaluated baseline characteristics, electrophysiology study (EPS) data and echocardiographic data for incidence of AF within 3 years. RESULTS: (66% vs 27%, p=0.004). Risk of incident AF in patients with LAVI > 40 mL/m2 was similar to that of LAVI 30-40 ml/m2 (67% vs 63%, respectively, p=0.97). In multivariable analysis LAVI remained the sole independent predictor of incidence AF after CTI AFL ablation. CONCLUSIONS: is associated with significantly increased risk of incident AF following CTI ablation for typical AFL. HATCH <2 was notably not an independent predictor of AF after AFL ablation.
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A 2020 study conducted a cohort in Typical cavotricuspid isthmus dependent atrial flutter (n=114). Left atrial volume index (LAVI) ≥ 30 ml/m2 vs. LAVI < 30 ml/m2 was evaluated on Incident atrial fibrillation (HR 2.25, 95% CI 1.14-4.45, p=0.02). Left atrial volume index ≥ 30 ml/m2 was independently associated with a increased risk of incident atrial fibrillation following cavotricuspid isthmus ablation for typical atrial flutter.
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