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Pulmonary vein isolation with additional substrate ablation for atrial fibrillation results in an increased risk for the development of atypical atrial flutter
Session:
Posters (Sessão 2 - Écran 1) - Arritmias - miscelânea
Speaker:
Inês Ferreira Neves
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
04. Arrhythmias, General
Subtheme:
04.7 Arrhythmias, General – Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Inês Ferreira Neves; Guilherme Portugal; Pedro Silva Cunha; Bruno Valente; Ana Lousinha; Helder Santos; André Monteiro; Rita Contins; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) catheter ablation. Several extra pulmonary vein (PV) ablation strategies for substrate modification (PVI plus) have been employed to AF patients. It has not been proven that this approach decreases the recurrence of AF, and it could contribute to increase the risk of developing atypical atrial flutter.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Methods</span></strong><span style="color:black">: Patients submitted to AF catheter ablation at our centre between 2005 and 2020 were included. Using logistic regression, we did a retrospective analysis of the association between the application of PVI plus strategies (such as ablation of the cavo tricuspid isthmus (CTI), ganglion plexus, isolation of the superior vena cava (SVC), mitral isthmus ablation and atrial roof line ablation) and the development of atypical flutter later submitted to ablation.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Results:</span></strong><span style="color:black"> Five hundred and seventy-five patients were included (64% males, age 57</span><span style="color:black">±</span><span style="color:black">12 years [between 14 and 81], 68.2% with paroxysmal AF) with > 1-year follow-up. Five hundred and five (87.8%) had PVI alone. From the 575 patients, 11 (1.9%) developed an atypical flutter during the follow-up, which was later submitted to ablation. The ODDS of a patient submitted to a PVI plus strategy developing atypical atrial flutter are 13.92 times higher than the one of those submitted to a stand-alone PVI technique, with a p value <0.001 (95% CI 3.96 – 48.87). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Conclusions</span></strong><span style="color:black">: Additional substrate ablation for AF significantly increases the risk of developing atypical auricular flutter. </span></span></span></span></p>
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