Nearly uniform failure of atrial flutter ablation and continuation of antiarrhythmic agents (hybrid therapy) for the long-term control of atrial fibrillation
Journal of Interventional Cardiac Electrophysiology , 05/17/2012
Anastasio N et al. – Hybrid therapy is not effective for long–term control of atrial fibrillation (AF). Patients should be counseled about the likelihood of eventual AF recurrence and anticoagulation should be maintained indefinitely when this strategy is used.Methods
- A consecutive, retrospective evaluation of all first time ablations of right atrial flutter at the University of Pennsylvania between August 2003 and August 2005 was performed (n=179).
- The study population consisted of 33 patients who had atrial flutter only after treatment of AF with class I antiarrhythmic drugs and was continued on them post–ablation.
- Follow–up data were obtained by reviewing records from the institution, from referring cardiologists, and from direct patient questionnaires.
- Atrial fibrillation recurrence was noted in 28 of 31 patients (90.3 %) who completed 5 years of follow–up.
- AF recurrence typically resulted in significant symptoms, although 21 % developed persistent AF and were eventually minimally symptomatic on a rate control strategy.
- A wide range of time to recurrence was observed (0.2–64.5 months) with 39 % recurring greater than 2 years post–ablation.