Skip to main content
SpringerLink
Log in

Quality of life and occurrence of atrial fibrillation in long-term follow-up of common type atrial flutter ablation:

Ablation with irrigated 5 mm tip and conventional 8 mm tip electrodes

  • ORIGINAL PAPER
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Objectives

The ablation of common type atrial flutter is mainly performed by two approved techniques, whose efficacy and outcome in terms of quality of life have not been evaluated so far in a long-term follow-up study over years. A high proportion of patients suffer from coexistent atrial fibrillation, which may worsen the ablation result. The question arises whether one technique is more effective than the other when immediate ablation results, the occurrence of atrial fibrillation and the quality of life are compared. Considering these facts, it is reasonable to think about new ablation strategies for common type atrial flutter in the era of new concepts in catheter ablation of atrial fibrillation.

Methods

In a retrospective study we evaluated a detailed questionnaire in 132 patients who underwent ablation of common type between 1999 and 2004. Radiofrequency ablation was performed irrespective of coexistent atrial fibrillation either with an irrigated tip or the 8 mm tip electrode. Acute and long-term ablation outcome, and the associated quality of life, pre-, under- and post-ablation was compared in the two different ablation groups. Recurrent tachycardia were re-evaluated by 12 lead ECG analysis and assessed for both ablation groups.

Results

88 (67%) of the 132 patients contacted answered the questionnaire polling the perceived benefits of the procedure. Of the other 44 patients (33%); 4 (3%) had died, 7 (5.3%) had moved, 33 patients (25%) could not be included due to missing or incoherent answers. Independent of the ablation technique there was a high acute and long-term ablation success rate at about 95%. After a mean of 3 years of follow-up this benefit persists in spite of a high proportion of recurrent tachycardia, mainly atrial fibrillation (55/88 patients, 59.1%). Despite the occurrence of secondary tachycardia, there was a high significant long-term symptomatic benefit in the state of healthy and daily practice work, evaluated with a p-value of < 0.0005. The frequency of episodes and the symptom "tachycardia" were significantly reduced after effective ablation of common type atrial flutter, p-values of 0.003 and 0.002, respectively.

Therefore the need for hospitalization was significant reduced (p = 0.001). Comparison of both approaches revealed that there was no significant difference related to the incidence and occurrence of atrial fibrillation.

Conclusions

The two mainly accepted and applied techniques for the ablation of common type atrial flutter show an excellent outcome under the aspect of ablation efficacy and quality of life in longterm follow-up. Three years after the ablation procedure the majority of patients consider the intervention beneficial. Despite the relatively high appearance of atrial fibrillation in the long-term follow-up this effect is still traceable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anne W, Willems R, Adriaenssens B et al (2006) Long-term symptomatic benefit after radiofrequency catheter ablation for atrial flutter despite a high incidence of post-procedural atrial fibrillation. Acta Cardiol 61(I):75–82

    Article  PubMed  Google Scholar 

  2. Anselme F, Saoudi N, Poty H et al (1999) Radiofrequency catheter ablation of common atrial flutter. Significance of palpitations and quality-oflife evaluation in patients with proven isthmus block. Circulation 99:534– 540

    PubMed  CAS  Google Scholar 

  3. Bernhardt P, Schmidt H, Sommer T et al (2006) Atrial fibrillation – Patients at high risk for cerebral embolism. Clin Res Cardiol 95:148–153

    Article  PubMed  CAS  Google Scholar 

  4. Bertaglia F, Zoppo F, Bonso A et al (2004) Long term follow up of radiofrequency catheter ablation of atrial flutter: clinical course and predictors of atrial fibrillation occurrence. Heart 90:59–63

    Article  PubMed  CAS  Google Scholar 

  5. Bielik H, Schrickel J, Shlevkov N et al (2005) Pharmacological and ablative hybrid therapy of atrial fibrillation. Long term effect on quality of life and arrhythmia-related symptoms. Z Kardiol 94:564–569

    Article  PubMed  CAS  Google Scholar 

  6. Calkins H, Canby R, Weiss R et al (2004) Results of catheter ablation of typical atrial flutter. Am J Cardiol 94:437–442

    Article  PubMed  Google Scholar 

  7. Da Costa A, Romeyer C, Mourot S et al (2002) Factors associated with early fibrillation after ablation of common atrial flutter. A single center prospective study. Eur Heart J 23:498–506

    Article  PubMed  CAS  Google Scholar 

  8. Granada J, Uribe W, Chyou PH et al (2000) Incidence and predictors of atrial flutter in the general population. J Am Coll Cardiol 36:2242–2246

    Article  PubMed  CAS  Google Scholar 

  9. Katritsis D, Iliodromitis E, Fragakis N et al (1996) Ablation therapy of type I atrial flutter may eradicate paroxysmal atrial fibrillation. Am J Cardiol 78:345–347

    Article  PubMed  CAS  Google Scholar 

  10. Kettering K, Greil G, Busch M et al (2006) Catheter ablation of atrial fibrillation: Ongoing atial fibrillation inside a single pulmonary vein after successful electrical disconnection and restoration of sinus rhythm in both atria. Clin Res Cardiol 95:663–667

    Article  PubMed  CAS  Google Scholar 

  11. Kleemann T, Becker T, Dönges K et al (2007) The prognostic impact of successful cardioversion of atrial fibrillation in patients with organic heart disease. Clin Res Cardiol 96:103–108

    Article  PubMed  CAS  Google Scholar 

  12. Lee SH, Tai CT, Yu WH et al (1999) Effects of radiofrequency catheter ablation on quality of life in patients with atrial flutter. Am J Cardiol 84:278–283

    Article  PubMed  CAS  Google Scholar 

  13. Movsowitz C, Callans DJ, Schartzmann D et al (1996) The results of atrial flutter ablation in patients with and without a history of atrial fibrillation. Am J Cardiol 78:93–96

    Article  PubMed  CAS  Google Scholar 

  14. Natale A, Newby KH, Pisano E et al (2000) Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol 35:1898–1904

    Article  PubMed  CAS  Google Scholar 

  15. O'Callaghan PA, Meara M, Kongsgaard E et al (2001) Symptomatic improvement after radiofrequency catheter ablation for typical atrial flutter. Heart 86:167–171

    Article  PubMed  Google Scholar 

  16. Ricci RP, Russound M, Santini M (2006) Management of atrial fibrillation. What are the possibilities of early detection with home monitoring. Clin Res Cardiol 95:10–16

    Article  Google Scholar 

  17. Strohmer B, Schernthanerund C, Pichler M (2006) Simultaneous angiographic imaging of ipsilateral pulmonary veins for catheter ablation of atrial fibrillation. Clin Res Cardiol 95:591–599

    Article  PubMed  CAS  Google Scholar 

  18. Tai CT, Chen SA, Chiang CE et al (1998) Long term outcome of radiofrequency catheter ablation for typical atrial flutter : risk prediction of recurrent arrhythmias. J Cardiovasc Electrophysiol 9:115–121

    Article  PubMed  CAS  Google Scholar 

  19. Wazni O, Marrouche NF, Martin DO et al (2003) Randomized study comparing combined pulmonary vein-left atrial junction disconnection and covotricuspid isthmus ablation versus pulmonary vein-left atrial junction disconnectionalone in patients with typical atrial flutter and atrial fibrillation. Circulation 108:2479–2483

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medizinische Klinik II, Schwerpunkte Kardiologie und Angiologie Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany

    Axel Meissner, Martin Christ, Petra Maagh, Rolf Borchard, Marc van Bracht, Ingo Wickenbrock, Hans-Joachim Trappe & Gunnar Plehn

Authors
  1. Axel Meissner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Christ
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Petra Maagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rolf Borchard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marc van Bracht
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ingo Wickenbrock
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans-Joachim Trappe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gunnar Plehn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Axel Meissner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meissner, A., Christ, M., Maagh, P. et al. Quality of life and occurrence of atrial fibrillation in long-term follow-up of common type atrial flutter ablation:. Clin Res Cardiol 96, 794–802 (2007). https://doi.org/10.1007/s00392-007-0559-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-007-0559-z

Key words

Search

Navigation