Outcomes After Ablation for Typical Atrial Flutter (from the Loire Valley Atrial Fibrillation Project)
Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of...
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| Veröffentlicht in: | The American journal of cardiology 2014-11, Vol.114 (9), p.1361-1367 |
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| creator | Clementy, Nicolas, MD Desprets, Laurent, MD Pierre, Bertrand, MD Lallemand, Bénédicte, MD Simeon, Edouard, MD Brunet-Bernard, Anne, MD Babuty, Dominique, MD, PhD Fauchier, Laurent, MD, PhD |
| description | Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p |
| doi_str_mv | 10.1016/j.amjcard.2014.07.066 |
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The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2014.07.066</identifier><identifier>PMID: 25200340</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Atrial Flutter - complications ; Atrial Flutter - physiopathology ; Atrial Flutter - surgery ; Cardiac arrhythmia ; Cardiovascular ; Catheter Ablation - methods ; Catheters ; Electrocardiography ; Female ; Follow-Up Studies ; France - epidemiology ; Heart attacks ; Humanities and Social Sciences ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate - trends ; Thromboembolism - epidemiology ; Thromboembolism - etiology</subject><ispartof>The American journal of cardiology, 2014-11, Vol.114 (9), p.1361-1367</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Nov 1, 2014</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-1c52cfe318fff6417ef17b7abb0ca170261a069b4223f4d9d432596b6a4a5e2a3</citedby><cites>FETCH-LOGICAL-c515t-1c52cfe318fff6417ef17b7abb0ca170261a069b4223f4d9d432596b6a4a5e2a3</cites><orcidid>0000-0002-9267-1658 ; 0000-0002-7415-0787</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914914015872$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25200340$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03677504$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Clementy, Nicolas, MD</creatorcontrib><creatorcontrib>Desprets, Laurent, MD</creatorcontrib><creatorcontrib>Pierre, Bertrand, MD</creatorcontrib><creatorcontrib>Lallemand, Bénédicte, MD</creatorcontrib><creatorcontrib>Simeon, Edouard, MD</creatorcontrib><creatorcontrib>Brunet-Bernard, Anne, MD</creatorcontrib><creatorcontrib>Babuty, Dominique, MD, PhD</creatorcontrib><creatorcontrib>Fauchier, Laurent, MD, PhD</creatorcontrib><title>Outcomes After Ablation for Typical Atrial Flutter (from the Loire Valley Atrial Fibrillation Project)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.</description><subject>Aged</subject><subject>Atrial Flutter - complications</subject><subject>Atrial Flutter - physiopathology</subject><subject>Atrial Flutter - surgery</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular</subject><subject>Catheter Ablation - methods</subject><subject>Catheters</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France - epidemiology</subject><subject>Heart attacks</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate - 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complications</topic><topic>Atrial Flutter - physiopathology</topic><topic>Atrial Flutter - surgery</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular</topic><topic>Catheter Ablation - methods</topic><topic>Catheters</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France - epidemiology</topic><topic>Heart attacks</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>Thromboembolism - epidemiology</topic><topic>Thromboembolism - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clementy, Nicolas, MD</creatorcontrib><creatorcontrib>Desprets, Laurent, MD</creatorcontrib><creatorcontrib>Pierre, Bertrand, MD</creatorcontrib><creatorcontrib>Lallemand, Bénédicte, MD</creatorcontrib><creatorcontrib>Simeon, Edouard, MD</creatorcontrib><creatorcontrib>Brunet-Bernard, Anne, MD</creatorcontrib><creatorcontrib>Babuty, Dominique, MD, PhD</creatorcontrib><creatorcontrib>Fauchier, Laurent, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>HAL-SHS: Archive ouverte en Sciences de l'Homme et de la Société</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clementy, Nicolas, MD</au><au>Desprets, Laurent, MD</au><au>Pierre, Bertrand, MD</au><au>Lallemand, Bénédicte, MD</au><au>Simeon, Edouard, MD</au><au>Brunet-Bernard, Anne, MD</au><au>Babuty, Dominique, MD, PhD</au><au>Fauchier, Laurent, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes After Ablation for Typical Atrial Flutter (from the Loire Valley Atrial Fibrillation Project)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>114</volume><issue>9</issue><spage>1361</spage><epage>1367</epage><pages>1361-1367</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25200340</pmid><doi>10.1016/j.amjcard.2014.07.066</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-9267-1658</orcidid><orcidid>https://orcid.org/0000-0002-7415-0787</orcidid></addata></record> |
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| subjects | Aged Atrial Flutter - complications Atrial Flutter - physiopathology Atrial Flutter - surgery Cardiac arrhythmia Cardiovascular Catheter Ablation - methods Catheters Electrocardiography Female Follow-Up Studies France - epidemiology Heart attacks Humanities and Social Sciences Humans Incidence Male Middle Aged Prognosis Retrospective Studies Risk Factors Survival Rate - trends Thromboembolism - epidemiology Thromboembolism - etiology |
| title | Outcomes After Ablation for Typical Atrial Flutter (from the Loire Valley Atrial Fibrillation Project) |
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