Risk of pacemaker implantation after uneventful successful cavotricuspid isthmus radiofrequency ablation in patients with common atrial flutter

详细信息    查看全文

• 作者：Moisé ; s Rodrí ; guez-Mañ ; ero^a ; ¹ ; ^{moirmanero@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Layla Gonz&aacute ; lez-Melchor^a ; ¹ ; Gabriel Ballesteros^b ; Sergio Raposeiras-Roubí ; n^a ; Javier Garcí ; a-Seara^a ; Xesú ; s Alberte Fern&aacute ; ndez Ló ; pez^a ; Cristina Gonz&aacute ; lez Cambeiro^a ; Oscar Alcalde^b ; Ignacio Garcí ; a-Bolao^b ; Luis Martí ; nez-Sande^a ; José ; Ramó ; n Gonz&aacute ; lez-Juanatey^a
• 关键词：AFL ; atrial flutter ; CTI ; cavotricuspid isthmus ; EPS ; electrophysiology study ; HR ; heart rate ; PMI ; pacemaker implantation ; RF ; radiofrequency
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 January 2016
• 年：2016
• 卷：202
• 期：Complete
• 页码：285-288
• 全文大小：349 K

文摘

Little is known about the risk of pacemaker implantation after common atrial flutter ablation in the long-term.

Methods

We retrospectively reviewed the electrophysiology laboratory database at two Spanish University Hospitals from 1998 to 2012 to identify patients who had undergone successful ablation for cavotricuspid dependent atrial flutter. Cox regression analysis was used to examine the risk of pacemaker implantation.

Results

A total of 298 patients were considered eligible for inclusion. The mean age of the enrolled patients was 65.7 ± 11. During 57.7 ± 42.8 months, 30 patients (10.1%) underwent pacemaker implantation. In the stepwise multivariate models only heart rate at the time of the ablation (OR: 0.96; 95% CI: 0.93–0.98; p < 0.0001) and intraventricular conduction disturbances in the baseline ECG (OR: 3.87; 95% CI: 1.54–9.70; p = 0.004) were independents predictors of the need of pacemaker implantation. A heart rate of ≤ 65 bpm was identified as the optimal cut-off value to predict the need of pacemaker implantation in the follow-up (sensitivity: 79%, specificity: 74%) by ROC curve analyses.

Conclusion

This is the first study of an association between the slow conducting common atrial flutter and subsequent risk of pacemaker implantation. In light of these findings, assessing it prior to ablation can be helpful for the risk stratification of sinus node disease or atrioventricular conduction disease requiring a pacemaker implantation in patients with persistent atrial flutter.