Key result
Ablation of typical atrial flutter within 30 days after cardiac surgery achieved 100% acute procedural success, with 92.7% of followed patients remaining in sinus rhythm at a median of 5.7 years.
Why the study?
Available data on the management of atrial flutter in the early postoperative setting after cardiac surgery are scarce.
Does ablation therapy improve long-term rhythm outcomes in patients with typical atrial flutter early after cardiac surgery?
Cohort (n=47)
No
Does ablation therapy improve long-term rhythm outcomes in patients with typical atrial flutter early after cardiac surgery?
Ablation of typical atrial flutter within 30 days after cardiac surgery is safe and highly effective, with the vast majority of patients maintaining sinus rhythm at long-term follow-up.
May support early ablation for post-surgical typical flutter; leaves open need for randomized confirmation of long-term benefit.
INTRODUCTION: Available data on management of atrial flutter in the early postoperative setting after cardiac surgery are scarce. We aimed to investigate the safety and efficacy (profile) of flutter ablation in the early postoperative phase (30 days after cardiac surgery) in a cohort of 47 consecutive patients. METHODS: Between 2007 and 2016, 47 patients who underwent ablation for postoperative typical atrial flutter were retrospectively identified and analyzed. Follow-up data were acquired from patients' records in case of rehospitalization and via follow-up calls. RESULTS: The median age of patients was 69 years, 89% male and with a median LV-EF of 55%. CAD was present in 80.8% of patients. The predominant conduction of atrial flutter was 2:1 (76.6%); 85.1% of patients had either undergone CABG, SAVR, or a combination of these two. Acute procedural success could be achieved in 100% of patients with one vascular pseudoaneurysm that was managed conservatively. No other complications occurred. After a median follow-up of 5.7 years, follow-up information regarding heart rhythm was available in 87.2% of patients. One patient (2.1%) had undergone repeat ablation for typical flutter. Two patients (4.2%) had developed atrial fibrillation, while 87.2% of patients were in sinus rhythm. CONCLUSIONS: In this small cohort, early postoperative ablation of typical flutter was associated with a favorable short- and long-term safety and efficacy profile and can be considered part of heart rhythm management options in this setting.
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Iden et al. (2021) conducted a cohort in Typical atrial flutter early after cardiac surgery (n=47). Ablation therapy was evaluated on Acute procedural success (bidirectional block of the cavotricuspid isthmus line). Ablation of typical atrial flutter within 30 days after cardiac surgery achieved 100% acute procedural success, with 92.7% of followed patients remaining in sinus rhythm at a median of 5.7 years.
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