Significant mitral regurgitation strongly predicted early atrial fibrillation (80% sensitivity, 78% specificity) in patients without prior AF undergoing common atrial flutter ablation.
Cohort (n=96)
No
Significant mitral regurgitation is a strong independent predictor of early atrial fibrillation following atrial flutter ablation in patients without a prior history of atrial fibrillation.
The occurrence of early atrial fibrillation ( or < or = 30 mmHg; right atrial area; left atrial area; isthmus block; number of radiofrequency applications (+/- SD); antiarrhythmic drugs at discharge; left ventricular diastolic diameter; left ventricular systolic diameter; left ventricular telediastolic volume; left ventricular telesystolic volume; A-wave velocity (cm . s(-1)); E-wave velocity (cm . s(-1)); E/A; isovolumetric relaxation time; E-wave deceleration time; significant mitral regurgitation and flutter cycle length (ms).Of the 96 consecutive ablated patients, early atrial fibrillation was documented in 16 patients (17%). Atrial fibrillation occurred 30 +/- 46 days (range 1 to 171 days) after ablation. Univariate analysis associated an early occurrence of atrial fibrillation with: atrial fibrillation history, left ventricular ejection fraction, left atrial size, left ventricular telesystolic volume, A-wave velocity, significant mitral regurgitation and flutter cycle length. Multivariate analysis using a Cox model found that the only independent predictors of early atrial fibrillation were left ventricular ejection fraction and pre-ablation history of atrial fibrillation. In the subgroup without prior atrial fibrillation history (n=63; 66%), the only independent predictor of early atrial fibrillation was the presence of a significant mitral regurgitation.In a subgroup of patients without atrial fibrillation history, 8% of patients revealed an early atrial fibrillation. Mitral regurgitation is a strong predictive factor of early atrial fibrillation occurrence with 80% sensitivity, 78% specificity and 98% negative predictive value. These data should be considered in post-ablation management.
Antoine Da Costa (Fri,) conducted a cohort in Common atrial flutter (n=96). Clinical and echocardiographic risk factors (e.g., mitral regurgitation, LVEF, prior AF) vs. Absence of risk factors was evaluated on Early atrial fibrillation (≤ 6 months). Significant mitral regurgitation strongly predicted early atrial fibrillation (80% sensitivity, 78% specificity) in patients without prior AF undergoing common atrial flutter ablation.