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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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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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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
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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
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Impact of the substrate on the success of atypical atrial flutter catheter ablation
Session:
Posters 2 - Écran 6 - Arritmologia
Speaker:
António Fontes
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.4 Supraventricular Tachycardia (non-AF) - Treatment
Session Type:
Posters
FP Number:
---
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><strong>Background:</strong> Structural heart disease, cardiac surgery and the widespread use of radiofrequency (RF) ablation for atrial fibrillation (AF) had led to the emergence of a large number of regular atrial tachycardias (frequently presenting as atypical atrial flutters (AAFs)). Electrophysiologic mapping enables us to understand and ablate different substrate of the arrhythmia although long term success is frequently related to the extent of left atrium remodeling.<br /> <strong>Objective:</strong> Our goal was to evaluate the impact of the underlying substrate in ablation success.<br /> <strong>Methods:</strong> We evaluated consecutive patients referred for ablation due to AAF from October 2007 to July 2018. Patients with prior history of AF ablation (PVI(+)) were compared to a subgroup of patients without prior history of left atrium ablation (PVI(-)). Clinical characteristics and electrophysiology study (EPS) data were compared between the 2 groups. The endpoints were defined as recurrence of AAF or recurrence of any supraventricular tachycardia (AF, AAF or atrial tachycardia).<br /> <strong>Results:</strong> A total of 90 AAF patients were included in the analysis, 34% without prior AF ablation (PVI(-) group).The PVI(-) subgroup had higher prevalence of heart failure (54% VS 19%,p<0,0001), cardiomyopathy and congenital heart diseases (26% VS 6,8%, p=0,012), CHA2DS2-VASc score (2,84±1,64 VS 2,03±1,35,p=0,014), EHRA score (2,7±0,9 VS 2,05±0,71,p=0,001) and left atrium volume (64 (52,5-94,0) VS 57,5 (44,4-70)mL/m2,p=0,026).During EPS, PVI(-) group presented more frequently in sinus rhythm at the begging of the study (48% VS 25%,p=0,023) and different flutter circuits were more often inducible after RF applications (42% VS 27%,p=0,048). During a median follow-up of 43 (13,5-80,5)months, AAF recurrence was more frequently observed in the PVI(-) group (52% VS 26%, p=0,015), although no significant differences in recurrence of all supraventricular tachycardias were observed between groups.<br /> <strong>Conclusion:</strong> In our series of patients submitted to AAF ablation, more than half of patients had prior history of AF ablation. AAF recurrence after ablation was less frequent in this subgroup although, no differences were observed regarding recurrence of all supraventricular tachycardias.</p>
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