Predictors of the atrial fibrillation following catheter ablation of typical atrial flutter.

BACKGROUND: Despite technical refinements and improved long-term efficacy of the ablation procedure for treating AFL (AFL), the subsequent occurrence of AF (AF) following this procedure remains a significant clinical problem.

OBJECTIVES: To determine long-term incidence and predictors of AF after catheter ablation of typical AFL.

MATERIAL AND METHODS: Between March 2005 and February 2010, a total of 84 consecutive patients who underwent catheter ablation of documented typical AFL were enrolled.

RESULTS: Cavotricuspid isthmus ablation was successful in terminating and preventing the re-induction of AFL in all 84 patients (100%). The mean follow-up duration for study was 26± 22 months. During the follow-up period, early AF occurred in 5% after successful catheter ablation of AFL and late AF in 11% of the patients. The clinical variables associated with the occurrence of AF after catheter ablation of AFL were female, a history of AF before AFL ablation, body mass index (BMI), and left atrial abnormality. However, logistic multivariate analysis demonstrated that only BMI was independently associated with the late AF (OR 1.36, 95% CI 1.11-1.70, P = 0.004).

CONCLUSIONS: Catheter ablation of flutter circuit will not prevent later manifestation of AF in 16% of the patients undergoing catheter ablation of the typical AFL. BMI was the only independent predictor of AF following catheter ablation of the typical AFL.