Predictors of early and late left atrial tachycardia and left atrial flutter after catheter ablation of atrial fibrillation: long-term follow-up

Cardiol J. 2015;22(5):557-66. doi: 10.5603/CJ.a2015.0040. Epub 2015 Jul 23.

Abstract

Background: The aim of the study was identification of the predictors of left atrial tachycardia and left atrial flutter (LATAFL) after radiofrequency catheter ablation of atrial fibrillation (CAAF).

Methods: We followed 598 patients (71% male, 41% paroxysmal AF; median follow-up: 36 months) after a single step-wise CAAF procedure. The time to first documented LATAFL lasting longer than 30 s, documented in any kind of electrocardiography (ECG), was defined as an end-point.

Results: A single CAAF procedure resulted in LATAF in 58 (10%) patients. Additional lesions were performed in 275 (46%) patients. Early LATAFL recurrence (£ 3 months since the index procedure) was observed in 11 (2%) patients. Late LATAFL (> 3 months) was noted in 47 (8%) patients. The univariate predictors of LATAFL recurrence were: type of AF (p = 0.003), the size of LA (p = 0.002) and the type of procedure (p = 0.0001). The identified single independent predictors of LATAFL recurrence were enlarged LA (p = 0.001) and mul-tiple (≥ 2) additional lesions performed during the index procedure (p < 0.0001).

Conclusions: Higher rate of LATAFL recurrence was observed in patients with non-paroxysmal AF, enlarged LA and any additional lesions performed. Two independent predictors of LATAFL recurrence after CAAF were: the enlarged LA and multiple (≥ 2) additional lesions performed during the index procedure.

Keywords: atrial fibrillation; catheter ablation; left atrial flutter; left atrial tachycardia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Atrial Flutter / diagnosis
  • Atrial Flutter / etiology*
  • Atrial Flutter / physiopathology
  • Catheter Ablation / adverse effects*
  • Disease-Free Survival
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Tachycardia, Supraventricular / diagnosis
  • Tachycardia, Supraventricular / etiology*
  • Tachycardia, Supraventricular / physiopathology
  • Time Factors
  • Treatment Outcome