Atrial fibrillation occurred in 23.2% of patients after atrial flutter ablation, with prior AF (OR 1.90; 95% CI 1.42-2.54) and female gender significantly increasing the risk.
Cohort (n=1,121)
Atrial fibrillation frequently occurs (>20%) after atrial flutter ablation, particularly in females and those with prior AF or prior use of class I antiarrhythmics/amiodarone, suggesting anticoagulation discontinuation should be carefully individualized.
Effect estimate: OR 1.90 (95% CI 1.42-2.54)
p-value: p=<0.001
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 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.
Brembilla-Perrot et al. (Fri,) conducted a cohort in Atrial flutter (n=1,121). Atrial flutter ablation was evaluated on Atrial fibrillation occurrence (OR 1.90, 95% CI 1.42-2.54, p=<0.001). Atrial fibrillation occurred in 23.2% of patients after atrial flutter ablation, with prior AF (OR 1.90; 95% CI 1.42-2.54) and female gender significantly increasing the risk.