Long Term Follow-up of Radiofrequency Catheter Ablation in Patients withTypical Atrial Flutter

Articol din publicatia Timisoara Medical Journal nr. 2/2005
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Constantin T. Luca, Dragos Cozma, Gabriel Ivanica, Lucian Vasiluta, Sorin Pescariu, Carmen G.Luca, Lucian Stoica, Constantin O. Luca, Stefan I. Dragulescu

Institute of Cardiovascular Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania

Correspondence to:
Ass. Prof. Constantin T. Luca, 9 J. Monet Str., 300766 Timisoara, Romania
Tel: +407445493340, +40256466015, Fax: +40256209232
Email: cluca@cardiologie.ro

ABSTRACT

Introduction: Radiofrequency (RF) ablation is widely used to cure symptomatic patients with typical atrial flutter. However, the long term results are debatable.

Aims: To assess the long term benefit of RF catheter ablation in patients with typical atrial flutter and to analyze the predictors for late recurrence. Material and method: Fourty-nine consecutive patients, sixteen women and thirty three men, mean age 54 years, referred for evaluation of typical atrial flutter, underwent endocardial atrial mapping and RF catheter ablation in the period between June 2000 and September 2003. Successful ablation was defined as achievement of bidirectional isthmus conduction block and no induction of atrial flutter after the procedure. All patients were consulted 1 month after the ablation, and then every 6 months up to 36 months.

Results: Atrial flutter was interrupted in all 49 patients with a mean number of applications of 19 ± 11, a fluoroscopic duration of 24 ± 15 minutes. Bidirectional conduction bloc was confirmed in 42 patients (85.71%). Six patients had recurrence of typical atrial flutter (5 of them only with unidirectional conduction block), all of them during the 6 months period after ablation. 5 of 8 patients with atrial flutter and previous atrial fibrillation had recurrence of atrial fibrillation. There were no significant complications during or after the procedure.

Conclusions: Radiofrequency catheter ablation of typical atrial flutter is a effective and safe procedure, associated with a low recurrence rate. Bidirectional conduction block and absence of previous atrial fibrillation are markers for positive prognostic.