Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
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
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Acute and long-term success of catheter ablation of atypical atrial flutter in patients with previous pulmonary vein isolation
Session:
Posters 5 - Écran 3 - Arritmologia
Speaker:
Pedro Miguel Oliveira Azevedo
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:
Pedro Oliveira De Azevedo; António Xavier Fontes; Gustavo Da Rocha Rodrigues; Elisabete Vaz; Rita Canuto; Francisco Moscoso Costa; Pedro Lopes Do Carmo; Diogo Cavaco; Francisco Bello Morgado; Pedro Adragão
Abstract
<p><strong>Introduction: </strong>Atypical atrial flutter frequently occurs in patients who have undergone previous medical procedures, such as cardiac surgery or pulmonary vein isolation (PVI) for the treatment of atrial fibrillation. Mapping and ablation of these complex arrhythmias continue to be a challenge and there are few studies addressing this issue.</p> <p><strong>Purpose: </strong>Characterize and evaluate the acute and long-term success of catheter ablation of atypical atrial flutter in patients with previous PVI.</p> <p><strong>Methods: </strong>Retrospective single center analysis of consecutive patients with previous pulmonary vein isolation undergoing catheter ablation of atypical atrial flutter from October 2007 to July 2018. Clinical profiles and procedural details were determined. We evaluated the acute success rate and long-term recurrence of AAF alone or a combination of AAF, atrial flutter or atrial fibrillation.</p> <p><strong>Results: </strong> A total of 59 patients (61% men with mean age 61.9 ± 10.3 years) were included. 54 (91.5%) had previously underwent catheter PVI, 5 (8.5%) had previous surgical radiofrequency PVI and 21 (35.6%) patients had a second catheter PVI procedure. A total of 52 (88.1%) AAF were mappable and distributed as follows: peri-mitral flutter (19, 32.2%), focal reentry through gaps in the prior PVI line (PVI-AAF) (19, 32.2%), LA-roof dependent flutter (11, 18.6%) and right atrium non-CTI flutter (3, 5.1%). High-density activation-sequence mapping was used in 22 (37.3%) of cases. A different AAF circuit after the first set of radiofrequency applications was seen in 13 (22%) patients. Acute success rate was achieved in 38 (64.4%) patients and was more likely to occur in patients with PVI-AAF (84.2% vs 15.8%, p = 0.029) and less likely in patients with more than one AAF circuit (25.9% vs 75.1%, p < 0,001). Over a mean follow-up of 46.1 ± 35 months, AAF recurred in 15 (25.4%) after a mean of 21.8 months (IQR 4–35) and 31 (52.5%) had recurrent atrial tachyarrhythmias (atrial fibrillation, AF or AAF). Although not statistically significant, there was a tendency for lower recurrence rate of AAF in patients who achieved sinus rhythm during ablation of the first mapped AAF (18.9% vs 38.1%, p = 0,09) or those who had left PV-dependent flutter (12.5% vs 28%, p = 0.3).</p> <p><strong>Conclusion: </strong>Catheter ablation of AAF is a complex procedure, with acute success observed in approximately 2 out of 3 patients. AAF involving gaps in prior PVI lines are more likely to be successfully ablated. During follow-up, approximately 25% and 50% had recurrent AAF or atrial tachyarrhythmias (AAF, atrial flutter or atrial fibrillation), respectively. There was a tendency for lower recurrence of AAF in patients who had left PV-dependent flutter or achieved sinus rhythm during ablation of the first mapped AAF.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site