番茄社区

NEW ORLEANS -- Atrial flutter ablation treatments were successful in virtually all cases, researchers said here at the annual meeting of the American College of Cardiology.

Among 3,983 patients treated in a 2-year period, doctors used radiofrequency ablation techniques to knock down the arrhythmia in 97.3% of cases, reported Etienne Luciani, MD, of St. Vincentius Hospital in Karlsruhe, Germany.

There was one death from a non-cardiac cause in the peritreatment period, but other major complications -- MI, stroke, or surgery-related deaths -- were not observed, he said. In nine patients, pacemakers were implanted.

There were 33 cases of recurrent atrial flutter that occurred before the patient could be discharged from the hospital.

Atrial fibrillation was observed in 3.3% of patients in the hospital. Most of the recurrent or new arrhythmias occurred in patients with no underlying heart disease.

"Acute and long-term results show that catheter ablation of atrial flutter is highly effective, with a very low complication rate," Luciani told 番茄社区 at his poster presentation.

He noted that the rate of success does not appear to be influenced by underlying heart disease or the clinical status of the patients.

"These were typical atrial flutter cases," Luciani said. They were treated between March 2007 and December 2009.

Atrial flutter recurred in about 28% of the patients after one-year followup, he reported.

Luciani said that ablation of atrial flutter is performed routinely, but treatment results are hard to establish.

So he and colleagues investigated the use and success of therapy in the German Ablation Registry, where:

• 2,993 men were treated for atrial flutter during the time frame, as were 990 women.
• Mean age of the patients undergoing the treatment was 68, but 699 of the patients were 75 years of age or older.
• Congestive heart failure was observed among 1,267 patients. No cardiac disease was seen in 44.3% of the cohort. About 70% of the patients had left ventricular ejection fractions greater than 50%.
• About 93% of the patients were undergoing their first ablation treatment.

The one-year followup information included data on 2,021 patients. Of that group, Luciani reported that 81 people died. Of those deaths, 26 were attributed to coronary causes and 20 to non-cardiac causes. The remaining 35 causes of death were not reported.

Luciani said 217 patients required recurrent ablation. About 1% of the patients in the follow-up cohort experienced a stroke; 0.9% experienced major bleeding episodes.

"I am not surprised that these doctors were able to achieve a success rate of more than 95% in performing the ablation techniques in atrial flutter patients," Mariell Jessup, MD, of the University of Pennsylvania, told 番茄社区.

"We think of atrial flutter as a slam dunk for ablation," said Jessup, who did not participate in the study.

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