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
Procedural related versus idiopathic atypical atrial flutter
Session:
Comunicações Orais - Sessão 15 - Fibrilhação Auricular e Flutter atípico
Speaker:
M. Inês Barradas
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.9 Atrial Fibrillation - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
M. Inês Barradas; Paulo Fonseca; João Almeida; Marco Oliveira; Helena Gonçalves; João Primo; Anabela Tavares; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white">Introduction: </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Atypical atrial flutter (AFLA) is a macro-reentrant atrial tachycardia not using the cavotricuspid isthmus (CTI). It<span style="background-color:white"> is often associated with cardiac surgery or previous ablation, mainly pulmonary vein isolation (PVI) and AFLA </span>not related to ablation or previous cardiac surgery is rare.</span></span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white">Methods: </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black"><span style="background-color:white">We performed a retrospective single-center review of all patients treated for AFLA ablation in our center from October 2008 to July 2022. </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white">Our study aimed to review and compare the incidence, clinical and </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">electrophysiologic characteristics</span></span></span> <span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">and acute and long-term results of AFLA ablation, according to previous atrial procedure. Three groups were defined: group 1 (G1) - idiopathic AFLA not related to previous ablation or cardiac surgery (n=18), group 2 (G2) - previous ablation (n=32) and group 3 (G3) - previous cardiac surgery (n=14). All patients underwent radiofrequency ablation with 3D mapping system.</span></span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white">Results: </span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">From 64 patients (</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">61.0 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 11.28 <span style="color:#212529"><span style="background-color:white">years, 60.9% male, follow-up (FUP) </span></span>58.5 </span></span><span style="font-size:11pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"> 47.79 months<span style="color:black">) 32 (50.0%) had previous catheter ablation</span><span style="color:#212529"><span style="background-color:white"> (</span></span><span style="color:black">35.9% PVI, 21.9% CTI, 3.1% accessory pathway</span><span style="color:#212529"><span style="background-color:white">), </span></span><span style="color:black">14 (21.9%) previous cardiac surgery</span><span style="color:#212529"><span style="background-color:white"> and </span></span><span style="color:black">18 (28.1%) corresponded to AFLA not related to ablation or previous cardiac surgery.</span> There were no significant differences in baseline demographic and clinical characteristics between the groups except for the higher prevalence of atrial fibrillation (AF) in G2 (p<0.01) and valvular and congenital heart disease in G3 (p<0.01). Echocardiographic data was similar between groups (<span style="color:#212529"><span style="background-color:white">left ventricular ejection fraction 55.1 </span></span></span></span><span style="font-size:11pt"><span style="font-family:Symbol"><span style="color:#212529"><span style="background-color:white">±</span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white"> 10.44%, moderate to severe left atrial (LA) dilatation in 25 (39.0%)). Low-voltage areas (LVA) were identified in 38 (59.4%) patients and were more prevalent in G1 (G1 77.8%, G2 46.9% and G3 71.4%, p=0.021). There was no difference in the number of induced AFLA (1.3 </span></span></span></span><span style="font-size:11pt"><span style="font-family:Symbol"><span style="color:#212529"><span style="background-color:white">±</span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white"> 0.74 AFLA per patient, in 7 (10.9%) no arrhythmia was induced), anatomical location (LA 70.3% and right atrium 29.7%) or ablation strategy (table 1). Concomitant PVI or re-PVI was more prevalent in G2 (G1 11.1%, 0.0%; G2 0.0%, 46.9%; G3 7.1%, 0.0%; p < 0.01) and ablation of ectopic pulmonary triggers in G1 (G1 44.4%, G2 6.3%, G3 21.4%, p < 0.01). Acute ablation success was achieved in 87.5% and was similar in all patients. Atrial arrhythmia (AA) recurrence (AF, atrial tachycardia or flutter) occurred in 32.8% at 1 year, 35.9% at 2 years and 40.6% at FUP (14.1 </span></span></span></span><span style="font-size:11pt"><span style="font-family:Symbol"><span style="color:#212529"><span style="background-color:white">±</span></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#212529"><span style="background-color:white"> 41.41 months after ablation) and was similar between groups, as well as visits to the emergency department due to AA, cardiovascular hospitalizations, ischemic stroke and death by all causes.</span></span></span></span></span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion: <span style="color:black">In our cohort of patients, p</span>atients with idiopathic AFLA had more frequently <span style="color:#212529"><span style="background-color:white">LVA suggestive of scaring or fibrosis, suggesting atrial cardiomyopathy. Although the additional ablation strategy differ between the groups, ablation success was achieved in the majority of patients and acute and long-term outcomes did not differ between the groups.</span></span></span></span></span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site