Evaluation of risk factors for long-term atrial fibrillation development in patients undergoing typical atrial flutter ablation: a multicenter pilot study.

Autor: Yumurtaş AÇ; Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey. ayumurtas@hotmail.com., Pay L; Department of Cardiology, Ardahan State Hospital, Ardahan, Turkey., Tezen O; Department of Cardiology, Bayrampaşa State Hospital, Istanbul, Turkey., Çetin T; Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey., Yücedağ FF; Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey., Arter E; Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey., Kadıoğlu H; Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey., Akgün H; Department of Cardiology, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey., Özkan E; Department of Cardiology, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey., Uslu A; Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey., Küp A; Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey., Şaylık F; Department of Cardiology, Van Traning and Research Hospital, Van, Turkey., Çınar T; Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA., Hayıroğlu Mİ; Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Training and Research Hospital, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Herz [Herz] 2024 Aug 13. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1007/s00059-024-05261-2
Abstrakt: Background: Atrial flutter (AFL) and atrial fibrillation (AF) are the most commonly detected supraventricular arrhythmias and share similar pathophysiological mechanisms. After the successful ablation of AFL, AF frequently occurs in the long-term follow-up. As emphasized in some studies, certain mechanisms seem to predispose to the development of AF in AFL patients, and approximately 20% of these patients have accompanying AFL.
Purpose: We aimed to analyze independent risk factors that predict the development of AF in patients who underwent typical AFL ablation.
Methods: This was a multicenter, cross-sectional, and retrospective study. A total of 442 patients who underwent typical AFL ablation at three different centers between January 1, 2018 and January 1, 2022 were included retrospectively. After the ablation procedure the patients were divided into those who developed AF and those who did not. The patients were followed up for an average of 12 (4-20) months. In the post-procedural period, atrial arrhythmias were investigated with 24‑h Holter and ECG at 1 month, 6 months, and 12 months and then at 6‑month intervals thereafter.
Results: Overall, AF developed in 206 (46.6%) patients in the long-term follow-up. Age, hypertension (HT), obstructive sleep apnea syndrome (OSAS), previous cerebrovascular accident (CVA), left atrium anteroposterior diameter, severe mitral regurgitation, hemoglobin, blood glucose, and HbA1c values were found to be significant in univariable analysis. According to multivariable analysis, HT (p = 0.014; HR: 1.483 [1.084-2.030]), OSAS (p = 0.008; HR: 1.520 [1.117-2.068]) and previous CVA (p = 0.038; HR: 1.749 [1.031-2.968]) were independently associated with the development of AF in AFL patients who underwent ablation procedure.
Conclusion: In the present study, we found that HT, OSAS, and previous CVA were independently correlated with the development of AF in the long-term follow-up of patients who underwent typical AFL ablation. We consider that AFL patients with such risk factors should be followed up closely following cavotricuspid isthmus ablation for the development of AF.
(© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
Databáze: MEDLINE
Externí odkaz: