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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Predictors of recurrence after catheter ablation of atypical atrial flutter
Session:
CO2 - Arritmias Supraventriculares
Speaker:
António Fontes
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.2 Supraventricular Tachycardia (non-AF) - Epidemiology, Prognosis, Outcome
Session Type:
Comunicações Orais
FP Number:
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Authors:
António Xavier Fontes; Pedro Oliveira De Azevedo; Gustavo Da Rocha Rodrigues; João Carmo; Maria Salomé Carvalho; Francisco Moscoso Costa; Pedro Lopes Do Carmo; Diogo Cavaco; Francisco Bello Morgado; Pedro Adragão
Abstract
<p>Background: Atypical atrial flutter (AAF) is often associated with structural heart disease, prior cardiac surgery or extensive catheter ablation for the treatment of atrial fibrillation (AF). The precise mechanism generating AAF can be mapped during electrophysiology studies (EPS) and ablation can be tailored to eliminate the reentrant circuit.</p> <p>Objective: The aim of the study is to assess the predictors of AAF recurrence after catheter ablation.</p> <p>Methods: Retrospective single center analysis of consecutive AAF patients referred for ablation from October 2007 to July 2018. Clinical characteristics and EPS features were evaluated. The primary endpoint was documented recurrence of AAF. Cox regression model was used to identify independent predictors of AAF recurrence.</p> <p>Results: A total of 90 AAF patients were included in the analysis, 57,7% male, with an median age of 64 (57,8-70,3) years old. The majority (88%) of the patients had a previous diagnosis of atrial fibrillation, prior AF ablation (76%) and a minority prior cardiac surgery with atriotomy (19%). During median follow-up of 43 (13,5-80,5)months, AAF recurrence was observed in 1/3 of the patients. Patients without recurrence after ablation had more frequently prior history of AF (94% VS 77%, p=0,013), have been more frequently submitted to pulmonary vein isolation (68% VS 45%, p=0,028) and presented more frequently spontaneous reversal to sinus rhythm during radiofrequency (RF) applications in the index procedure (68% VS 45%, p=0,028).Conversion to sinus rhythm during RF ablation independently predicted ablation success during follow up (HR 2,4, 95% CI 1,03-5,63; p=0,043).</p> <p>Conclusion: In our population of AAF patients submitted to a first procedure of ablation, spontaneous conversion to sinus rhythm during RF energy delivery was the most powerful predictor of success during follow up and was associated with 2,4 chance of remaining without the arrhythmia.</p>
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