Relation between left atrial size and secondary atrial arrhythmias after successful catheter ablation of common atrial flutter

被引:13
作者
Frey, B [1 ]
Kreiner, G [1 ]
Binder, T [1 ]
Heinz, G [1 ]
Baumgartner, H [1 ]
Gossinger, HD [1 ]
机构
[1] Univ Vienna, Klin Innere Med 2, Abt Kardiol, Dept Internal Med 2, A-1090 Vienna, Austria
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 1997年 / 20卷 / 12期
关键词
catheter ablation; atrial flutter; atrial fibrillation;
D O I
10.1111/j.1540-8159.1997.tb05463.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Catheter ablation provides an effective cure for patients with typical atrial flutter. However, these patients may have the potential to develop atrial tachyarrhythmias other than common atrial flutter, This study examines clinical and echocardiographic predictors for the occurrence of uncommon atrial flutter or atrial fibrillation after abolition of common atrial flutter. The study population comprised 17 patients (12 men, 5 women, age 32-74 years) who underwent successful radiofrequency catheter ablation of common atrial flutter. Common atrial flutter did not recur in any patient during a median follow-up time of 8 (range 1-25) months. Within a median of 7 (range 1-223) days, however, symptomatic atrial tachyarrhythmias occurred in 8 of 17 patients (47%): uncommon atrial flutter (n = 4); atrial fibrillation (n = 3); and both uncommon atrial flutter and atrial fibrillation in one pat patient. Preablation left atrial volume tvas significantly larger in patients who developed secondary arrhythmias compared with patients who remained in sinus rhythm (57.9 +/- 15.6 vs 43.7 +/- 16.4 cm(3), P < 0.05). Enlarged left atrial volume dichotomized at 51 cm(3) independently predicted postablation atrial arrhythmias (x(2) = 5.11, rel. risk = 5.3, P < 0.05). On Kaplan-Meier analysis, time to occurrence of postablation atrial arrhythmias was significantly shorter in patients with enlarged left atrium (P < 0.02). in conclusion, symptomatic uncommon atrial flutter and atrial fibrillation develops in a substantial proportion of patients after successful ablation of common atrial flutter. Out of a series of clinical and echocardiographic parameters, preablation left atrial size is the best predictor for the occurrence of these postablation atrial arrhythmias.
引用
收藏
页码:2936 / 2942
页数:7
相关论文
共 23 条
[1]  
*AM SOC ECH COMM S, 1989, J AM SOC ECHOCARDIOG, V2, P358
[2]  
BARUCH L, 1995, J AM COLL CARDIOL S, V95, pA203
[3]   CATHETER ABLATION OF ATRIAL-FLUTTER USING RADIOFREQUENCY ENERGY [J].
CALKINS, H ;
LEON, AR ;
DEAM, AG ;
KALBFLEISCH, SJ ;
LANGBERG, JJ ;
MORADY, F .
AMERICAN JOURNAL OF CARDIOLOGY, 1994, 73 (05) :353-356
[4]   Electrophysiological effects of catheter ablation of inferior vena cava-tricuspid annulus isthmus in common atrial flutter [J].
Cauchemez, B ;
Haissaguerre, M ;
Fischer, B ;
Thomas, O ;
Clementy, J ;
Coumel, P .
CIRCULATION, 1996, 93 (02) :284-294
[5]   RADIOFREQUENCY ABLATION OF THE INFERIOR VENA-CAVA - TRICUSPID-VALVE ISTHMUS IN COMMON ATRIAL-FLUTTER [J].
COSIO, FG ;
LOPEZGIL, M ;
GOICOLEA, A ;
ARRIBAS, F ;
BARROSO, JL .
AMERICAN JOURNAL OF CARDIOLOGY, 1993, 71 (08) :705-709
[6]   MECHANISMS OF ENTRAINMENT OF HUMAN COMMON FLUTTER STUDIED WITH MULTIPLE ENDOCARDIAL RECORDINGS [J].
COSIO, FG ;
GIL, ML ;
ARRIBAS, F ;
PALACIOS, J ;
GOICOLEA, A ;
NUNEZ, A .
CIRCULATION, 1994, 89 (05) :2117-2125
[7]   RADIOFREQUENCY CATHETER ABLATION FOR THE TREATMENT OF HUMAN TYPE-1 ATRIAL-FLUTTER - IDENTIFICATION OF A CRITICAL ZONE IN THE REENTRANT CIRCUIT BY ENDOCARDIAL MAPPING TECHNIQUES [J].
FELD, GK ;
FLECK, RP ;
CHEN, PS ;
BOYCE, K ;
BAHNSON, TD ;
STEIN, JB ;
CALISI, CM ;
IBARRA, M .
CIRCULATION, 1992, 86 (04) :1233-1240
[8]   RADIOFREQUENCY CATHETER ABLATION OF COMMON ATRIAL-FLUTTER IN 80 PATIENTS [J].
FISCHER, B ;
HAISSAGUERRE, M ;
GARRIGUES, S ;
POQUET, F ;
GENCEL, L ;
CLEMENTY, J ;
MARCUS, FI .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1995, 25 (06) :1365-1372
[9]   CHANGES IN LEFT AND RIGHT ATRIAL SIZE AFTER CARDIOVERSION OF ATRIAL-FIBRILLATION - ROLE OF MITRAL-VALVE DISEASE [J].
GOSSELINK, ATM ;
CRIJNS, HJGM ;
HAMER, HPM ;
HILLEGE, H ;
LIE, KI .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1993, 22 (06) :1666-1672
[10]   RADIOFREQUENCY ABLATION OF ATRIAL-FLUTTER - EFFICACY OF AN ANATOMICALLY GUIDED APPROACH [J].
KIRKORIAN, G ;
MONCADA, E ;
CHEVALIER, P ;
CANU, G ;
CLAUDEL, JP ;
BELLON, C ;
LYON, L ;
TOUBOUL, P .
CIRCULATION, 1994, 90 (06) :2804-2814