RT-162
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Atrial flutter radiofrequency
catheter ablation modifies the recurrence of atrial fibrillation?
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A. Bonso, G. Gasparini, S.
Temistoclakis, P. Delise*, L. Coro*, L. Targa, L. Patrassi, A. Raviele.
Cardiologic Operative Units, Hospitals of Mestre and *Feltre, Italy
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Abstract
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Radiofrequency (RF) catheter ablation is successfully
used for the treatment of atrial flutter (AF), however few information are available
regarding occurrence of atrial fibrillation (af), after RF. Data are reported from 32
patients (27 m, 5 f; age 55 ± 13 years; symptoms duration 88 ± 46 months), with typical
AF, who underwent ablation. Twenty-six patients (81%) presented recurrent paroxysmal AF,
with or without af, despite the therapy with antiarrhythmic drugs (2.7 ± 1), 6 patients
(19%) had chronic AF. Before RF, 12 patients (37.5%) had history of AF/af (group I), while
20 patients (62.5%) had only AF (group II). Twenty-four patients (75%) had heart disease.
Results. Ablation was successfully performed in the 90.6% of cases,
during AF (50%) and in sinus rhythm (50%). AF recurred in 11 patients (34%); after
repeated RF procedures, no further AF recurrence was observed, up to now, in 72% of these
patients. All patients were discharged without antiarrhythmic drug therapy. During
follow-up (20 ± 13 months) af recurred in 10 patients of group I (83%) and new onset of
af was observed in 3 patients of group II (15%). The occurrence of af, after treatment
with antiarrhythmic drugs of class Ic (propafenone and flecainide 75%) and class III
(amiodarone and sotalol 19%), was 1. abolished in 5 patients of group I (50%) and in 2
patients of group II (66%); 2. significantly reduced in 4 patients of group I (40%); 3.
still present in 1 patient of group I (10%) and in 1 patient of group II (33%).
Conclusions. RF ablation was successfully used for the treatment of
AF. After RF, af recurrence was frequently observed in patients with AF/af (group I);
whereas new af onset was low in patients with AF (group II). Moreover, after RF, af
treatment with antiarrhythmic drugs (class Ic and III) was effective in patients of group
I and group II, suggesting that RF catheter ablation might be useful not only for the
therapy of AF, but might also improve the treatment of af.
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Key Words
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Catheter ablation of supraventricular
tachyarrhythmias
atrial flutter, recurrence of AF, class Ia, Ic, III drugs, propafenone,flecainide,
amiodarone, sotalol, quinidine, OA
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