Two high-volume institutions in Taiwan were included in this study, namely, Taipei Veterans General Hospital and Cheng Hsin General Hospital. This is a retrospective study that enrolled patients with a history of surgical intervention for VHD who underwent AFL catheter ablation. Moreover, the predictors of recurrent atrial tachyarrhythmia for this patient group were determined. The type of flutter, impact of AF, and electrophysiologic mechanism were analyzed. Our present study aimed to analyze the long-term outcomes after AFL catheter ablation in patients with prior cardiac surgery for valvular heart disease (VHD), including mitral, tricuspid, and aortic valve surgery and concomitant coronary artery bypass surgery (CABG). Repeated procedure could achieve a favorable outcome ( 11). reported that macro-reentry was the predominant mechanism of atrial tachycardia (AT) in patients with mitral valve (MV) surgery. The mean following period was relatively short term (12 months) ( 10). demonstrated that the success rate of ablation of atrial arrhythmia after open heart surgery (included CHD and valvular surgery) is ≥90%. The type of cardiac surgery was not emphasized in this study ( 9). The patients with prior cardiac surgery were likely to have a lower freedom from AFL and atrial fibrillation (AF) after AFL ablation than those without. had compared the ablation outcome of AFL between patients with and without prior cardiac surgery. As for acquired heart disease, Aktas et al. It had been demonstrated that atypical AFL after surgery for congenital heart disease (CHD) could be successfully ablated in 50–90% of circuits with traditional entrainment or a three-dimensional (3D) mapping system ( 1– 4, 7, 8). Radiofrequency (RF) catheter ablation could be considered as the first-line therapy for atypical AFL when compared with antiarrhythmic drugs in patients with cardiac surgery history ( 6). In patients with prior cardiac surgery, atrial flutter (AFL) may develop with the critical isthmus located at the region bounded by surgical scar and the anatomical structure of the right or left atrium ( 1– 5). CKD and LAD independently predicted recurrence after AFL ablation in patients who have undergone cardiac surgery for VHD. Multivariate analysis showed that chronic kidney disease (CKD) and left atrial diameter (LAD) were independent predictors of recurrence.Ĭonclusions: In our study cohort, concomitant AF was associated with recurrence of atrial tachyarrhythmia. Regarding patients without AF, the typical AFL group had a lower recurrence rate of atrial tachyarrhythmia than the atypical AFL group (14 vs. In subgroup analysis, typical AFL patients with concomitant AF had a higher incidence of recurrent atrial tachyarrhythmia than those without it (53 vs. Patients with concomitant atrial fibrillation (AF) had a higher recurrence of typical AFL compared with those without AF (13 vs. ![]() Results: No significant difference was found in the recurrence rate of atrial tachyarrhythmia between the two groups. A multivariate analysis was performed to determine the predictor of recurrence. ![]() The endpoint was the recurrence of atrial tachyarrhythmia during follow-up. The patients were categorized into a typical AFL group ( n = 45) and an atypical AFL group ( n = 27). Methods: Seventy-two patients with prior cardiac surgery for VHD who underwent AFL ablation were included. This study aimed to investigate the outcome and predictor of recurrent atrial tachyarrhythmia after catheter ablation in patients with prior cardiac surgery for valvular heart disease (VHD) who presented with AFL. Background: Surgical scars cause an intra-atrial conduction delay and anatomical obstacles that facilitate the perpetuation of atrial flutter (AFL).
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