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Comparison of in-hospital outcomes of patients undergoing catheter ablation for typical versus atypical atrial flutter

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Catheter ablation (CA) is indicated as definitive therapy for patients with either typical or atypical atrial flutter (TAFlutter and AAFlutter, respectively) which is unresponsive to medical therapy. There is a paucity of data regarding in-hospital outcomes of patients undergoing CA.

Methods

Retrospective study using the NIS to identify patients ≥18 years who underwent CA between 2015 and 2017. Individuals were identified using ICD-10-CM/PCS for TAFlutter, AAFlutter, and CA.

Results

A total of 17,390 patients underwent CA for Aflutter (33% AAFlutter and 67% TAFlutter). The TAFlutter group was younger (mean 65.9 years vs. 67.2 years), with less females (30% vs. 43%, p ≤ 0.001 for both) compared to the AAFlutter group. The TAFlutter group had a higher rate of diabetes, tobacco use, obesity, and chronic obstructive pulmonary disease (p ≤ 0.001 for all). The AAFlutter cohort had increased prior strokes and atrial fibrillation (p ≤ 0.001 for both). The mean CHA2DS2-VASc score was found to be 2.3 in AAFlutter compared to 2.1 in TAFlutter (p ≤ 0.001). There were significantly higher proportions of thromboembolic events, transfusions, and longer length of stay in the TAFlutter group (p ≤ 0.001 for all) with the AAFlutter group having significantly higher rates of cardioversion, implantation of cardiac devices, and increased hospital charges (p ≤ 0.001 for all); no significant difference was found in mortality after controlling for comorbidities.

Conclusions

We found higher complication rates in CA for patients with TAFlutter, but no difference in in-hospital all-cause mortality. Variation in CA depending upon the mechanism of AFlutter may underlie these differences, and warrant further study.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Miami Hospital Miller School of Medicine/Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL, 33136, USA

    Bertrand Ebner, Jelani Grant, Louis Vincent & Jennifer Maning

  2. Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA

    Odunayo Olorunfemi, Neal Olarte & Litsa Lambrakos

  3. Cardiovascular Division, Jackson Memorial Hospital, Miami, FL, USA

    Rosario Colombo & Ivan Mendoza

Authors
  1. Bertrand Ebner
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  2. Jelani Grant
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  3. Louis Vincent
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  4. Jennifer Maning
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  5. Odunayo Olorunfemi
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  6. Neal Olarte
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Correspondence to Bertrand Ebner.

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The authors confirm no relationship with industry, disclosures, or source of funding for the work presented in this manuscript. Institutional review board approval was not needed and informed consent was waived, as all patient information is de-identified within the NIS. All data under NIS are publicly available.

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Ebner, B., Grant, J., Vincent, L. et al. Comparison of in-hospital outcomes of patients undergoing catheter ablation for typical versus atypical atrial flutter. J Interv Card Electrophysiol 63, 295–302 (2022). https://doi.org/10.1007/s10840-021-00982-4

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  • DOI: https://doi.org/10.1007/s10840-021-00982-4

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