Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation

Aims: The aim was to describe the incidence of atrial fibrillation (AF) after cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) without history of AF and to identify risk factors for new-onset AF after the procedure.Methods: A total of 191 patients with typical AFL u...

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Autores principales:	Jia-hui Li, Hai-yang Xie, Yan-qiao Chen, Zhong-jing Cao, Qing-hui Tang, Xiao-gang Guo, Qi Sun, Jian Ma
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	typical atrial flutter atrial fibrillation catheter ablation advanced interatrial block (aIAB) left atrial diameter (LAD) CHA2DS2-VASc score Physiology QP1-981
Acceso en línea:	https://doaj.org/article/2d6d7925381f4ffca01a98ecd714202d
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spelling	oai:doaj.org-article:2d6d7925381f4ffca01a98ecd714202d2021-12-01T18:18:55ZRisk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation1664-042X10.3389/fphys.2021.763478https://doaj.org/article/2d6d7925381f4ffca01a98ecd714202d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphys.2021.763478/fullhttps://doaj.org/toc/1664-042XAims: The aim was to describe the incidence of atrial fibrillation (AF) after cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) without history of AF and to identify risk factors for new-onset AF after the procedure.Methods: A total of 191 patients with typical AFL undergoing successful CTI ablation were enrolled. Patients who had history of AF, structural heart disease, cardiac surgery, or ablation or who received antiarrhythmic drug after procedure were excluded. Clinical and electrophysiological data were collected.Results: There were 47 patients (24.6%) developing new AF during a follow-up of 3.3 ± 1.9 years after CTI ablation. Receiver operating characteristic (ROC) curves indicated that the cut-off values of left atrial diameter (LAD) and CHA2DS2-VASc score were 42 mm and 2, with area under the curve of 0.781 and 0.550, respectively. The multivariable Cox regression analysis revealed that obstructive sleep apnea (OSA) [hazard ratio (HR) 3.734, 95% confidence interval (CI) 1.470–9.484, P = 0.006], advanced interatrial block (aIAB) (HR 2.034, 95% CI 1.017–4.067, P = 0.045), LAD > 42 mm (HR 2.710, 95% CI 1.478–4.969, P = 0.001), and CHA2DS2-VASc score > 2 (HR 2.123, 95% CI 1.118–4.034, P = 0.021) were independent risk factors of new-onset AF.Conclusion: A combination of OSA, aIAB, LAD > 42 mm, and CHA2DS2-VASc > 2 was a strongly high risk for new-onset AF after ablation for typical AFL, and it had significance in postablation management in clinical practice.Jia-hui LiHai-yang XieYan-qiao ChenZhong-jing CaoQing-hui TangXiao-gang GuoQi SunJian MaFrontiers Media S.A.articletypical atrial flutteratrial fibrillationcatheter ablationadvanced interatrial block (aIAB)left atrial diameter (LAD)CHA2DS2-VASc scorePhysiologyQP1-981ENFrontiers in Physiology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	typical atrial flutter atrial fibrillation catheter ablation advanced interatrial block (aIAB) left atrial diameter (LAD) CHA2DS2-VASc score Physiology QP1-981
spellingShingle	typical atrial flutter atrial fibrillation catheter ablation advanced interatrial block (aIAB) left atrial diameter (LAD) CHA2DS2-VASc score Physiology QP1-981 Jia-hui Li Hai-yang Xie Yan-qiao Chen Zhong-jing Cao Qing-hui Tang Xiao-gang Guo Qi Sun Jian Ma Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
description	Aims: The aim was to describe the incidence of atrial fibrillation (AF) after cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) without history of AF and to identify risk factors for new-onset AF after the procedure.Methods: A total of 191 patients with typical AFL undergoing successful CTI ablation were enrolled. Patients who had history of AF, structural heart disease, cardiac surgery, or ablation or who received antiarrhythmic drug after procedure were excluded. Clinical and electrophysiological data were collected.Results: There were 47 patients (24.6%) developing new AF during a follow-up of 3.3 ± 1.9 years after CTI ablation. Receiver operating characteristic (ROC) curves indicated that the cut-off values of left atrial diameter (LAD) and CHA2DS2-VASc score were 42 mm and 2, with area under the curve of 0.781 and 0.550, respectively. The multivariable Cox regression analysis revealed that obstructive sleep apnea (OSA) [hazard ratio (HR) 3.734, 95% confidence interval (CI) 1.470–9.484, P = 0.006], advanced interatrial block (aIAB) (HR 2.034, 95% CI 1.017–4.067, P = 0.045), LAD > 42 mm (HR 2.710, 95% CI 1.478–4.969, P = 0.001), and CHA2DS2-VASc score > 2 (HR 2.123, 95% CI 1.118–4.034, P = 0.021) were independent risk factors of new-onset AF.Conclusion: A combination of OSA, aIAB, LAD > 42 mm, and CHA2DS2-VASc > 2 was a strongly high risk for new-onset AF after ablation for typical AFL, and it had significance in postablation management in clinical practice.
format	article
author	Jia-hui Li Hai-yang Xie Yan-qiao Chen Zhong-jing Cao Qing-hui Tang Xiao-gang Guo Qi Sun Jian Ma
author_facet	Jia-hui Li Hai-yang Xie Yan-qiao Chen Zhong-jing Cao Qing-hui Tang Xiao-gang Guo Qi Sun Jian Ma
author_sort	Jia-hui Li
title	Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
title_short	Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
title_full	Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
title_fullStr	Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
title_full_unstemmed	Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation
title_sort	risk of new-onset atrial fibrillation post-cavotricuspid isthmus ablation in typical atrial flutter without history of atrial fibrillation
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/2d6d7925381f4ffca01a98ecd714202d
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Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation

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