Severe left ventricular systolic dysfunction increases atrial fibrillation after ablation of atrial flutter

Peter E. Zambito, Ashok Talreja, Susheel Gundewar, John Devens Fisher, Kevin J. Ferrick, Jay N. Gross, Soo G. Kim, Eugen C. Palma

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Atrial fibrillation (Afib) that occurs after a successful atrial flutter (AFL) ablation may negate the potential benefits of the ablation. Afib occurs more often when severe left ventricular systolic dysfunction (LVSD) is present. We hypothesized that even after a successful AFL ablation, the incidence of postablation Afib is increased when severe LVSD is present. Methods: Ninety consecutive patients with LVSD who underwent ablation for AFL at Montefiore Medical Center from August 2001 to January 2005 were classified according to the severity of LVSD. Group 1 (n = 36) consisted of patients with EF ≤ 35%, and group 2 (n = 54) consisted of patients with EF 36-55%. There were no statistically significant differences in baseline patient characteristics between the two groups. Results: During a mean follow up of 350 days, Afib occurred in 31% (n = 11; 8 with prior history of AFib) in group 1, and 7.4% (n = 4; all with prior history of Afib) in group 2. Cumulative probability of remaining Afib-free in group 1 versus group 2 was 75% versus 96% at 365 days, and 69% versus 91% at 600 days (P = 0.01). A prior history of Afib did not interact with EF when analyzed with a logistic regression analysis. Conclusion: After an AFL ablation, the incidence of Afib is increased, and the probability of remaining free of Afib is decreased, when severe LVSD is present, independent of a prior history of Afib. This finding may have implications for optimal patient selection for AFL ablation, and the use of adjunctive therapies.

Original languageEnglish (US)
Pages (from-to)1055-1059
Number of pages5
JournalPACE - Pacing and Clinical Electrophysiology
Volume28
Issue number10
DOIs
StatePublished - Oct 2005

Fingerprint

Atrial Flutter
Left Ventricular Dysfunction
Atrial Fibrillation
Incidence
Patient Selection
Logistic Models
Regression Analysis

Keywords

  • Ablation
  • Atrial fibrillation
  • Congestive heart failure
  • Electrophysiology - clinical

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Severe left ventricular systolic dysfunction increases atrial fibrillation after ablation of atrial flutter. / Zambito, Peter E.; Talreja, Ashok; Gundewar, Susheel; Fisher, John Devens; Ferrick, Kevin J.; Gross, Jay N.; Kim, Soo G.; Palma, Eugen C.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 28, No. 10, 10.2005, p. 1055-1059.

Research output: Contribution to journalArticle

@article{79a264cdaea04c6c8dda47caac8bd9c1,
title = "Severe left ventricular systolic dysfunction increases atrial fibrillation after ablation of atrial flutter",
abstract = "Background: Atrial fibrillation (Afib) that occurs after a successful atrial flutter (AFL) ablation may negate the potential benefits of the ablation. Afib occurs more often when severe left ventricular systolic dysfunction (LVSD) is present. We hypothesized that even after a successful AFL ablation, the incidence of postablation Afib is increased when severe LVSD is present. Methods: Ninety consecutive patients with LVSD who underwent ablation for AFL at Montefiore Medical Center from August 2001 to January 2005 were classified according to the severity of LVSD. Group 1 (n = 36) consisted of patients with EF ≤ 35{\%}, and group 2 (n = 54) consisted of patients with EF 36-55{\%}. There were no statistically significant differences in baseline patient characteristics between the two groups. Results: During a mean follow up of 350 days, Afib occurred in 31{\%} (n = 11; 8 with prior history of AFib) in group 1, and 7.4{\%} (n = 4; all with prior history of Afib) in group 2. Cumulative probability of remaining Afib-free in group 1 versus group 2 was 75{\%} versus 96{\%} at 365 days, and 69{\%} versus 91{\%} at 600 days (P = 0.01). A prior history of Afib did not interact with EF when analyzed with a logistic regression analysis. Conclusion: After an AFL ablation, the incidence of Afib is increased, and the probability of remaining free of Afib is decreased, when severe LVSD is present, independent of a prior history of Afib. This finding may have implications for optimal patient selection for AFL ablation, and the use of adjunctive therapies.",
keywords = "Ablation, Atrial fibrillation, Congestive heart failure, Electrophysiology - clinical",
author = "Zambito, {Peter E.} and Ashok Talreja and Susheel Gundewar and Fisher, {John Devens} and Ferrick, {Kevin J.} and Gross, {Jay N.} and Kim, {Soo G.} and Palma, {Eugen C.}",
year = "2005",
month = "10",
doi = "10.1111/j.1540-8159.2005.00223.x",
language = "English (US)",
volume = "28",
pages = "1055--1059",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Severe left ventricular systolic dysfunction increases atrial fibrillation after ablation of atrial flutter

AU - Zambito, Peter E.

AU - Talreja, Ashok

AU - Gundewar, Susheel

AU - Fisher, John Devens

AU - Ferrick, Kevin J.

AU - Gross, Jay N.

AU - Kim, Soo G.

AU - Palma, Eugen C.

PY - 2005/10

Y1 - 2005/10

N2 - Background: Atrial fibrillation (Afib) that occurs after a successful atrial flutter (AFL) ablation may negate the potential benefits of the ablation. Afib occurs more often when severe left ventricular systolic dysfunction (LVSD) is present. We hypothesized that even after a successful AFL ablation, the incidence of postablation Afib is increased when severe LVSD is present. Methods: Ninety consecutive patients with LVSD who underwent ablation for AFL at Montefiore Medical Center from August 2001 to January 2005 were classified according to the severity of LVSD. Group 1 (n = 36) consisted of patients with EF ≤ 35%, and group 2 (n = 54) consisted of patients with EF 36-55%. There were no statistically significant differences in baseline patient characteristics between the two groups. Results: During a mean follow up of 350 days, Afib occurred in 31% (n = 11; 8 with prior history of AFib) in group 1, and 7.4% (n = 4; all with prior history of Afib) in group 2. Cumulative probability of remaining Afib-free in group 1 versus group 2 was 75% versus 96% at 365 days, and 69% versus 91% at 600 days (P = 0.01). A prior history of Afib did not interact with EF when analyzed with a logistic regression analysis. Conclusion: After an AFL ablation, the incidence of Afib is increased, and the probability of remaining free of Afib is decreased, when severe LVSD is present, independent of a prior history of Afib. This finding may have implications for optimal patient selection for AFL ablation, and the use of adjunctive therapies.

AB - Background: Atrial fibrillation (Afib) that occurs after a successful atrial flutter (AFL) ablation may negate the potential benefits of the ablation. Afib occurs more often when severe left ventricular systolic dysfunction (LVSD) is present. We hypothesized that even after a successful AFL ablation, the incidence of postablation Afib is increased when severe LVSD is present. Methods: Ninety consecutive patients with LVSD who underwent ablation for AFL at Montefiore Medical Center from August 2001 to January 2005 were classified according to the severity of LVSD. Group 1 (n = 36) consisted of patients with EF ≤ 35%, and group 2 (n = 54) consisted of patients with EF 36-55%. There were no statistically significant differences in baseline patient characteristics between the two groups. Results: During a mean follow up of 350 days, Afib occurred in 31% (n = 11; 8 with prior history of AFib) in group 1, and 7.4% (n = 4; all with prior history of Afib) in group 2. Cumulative probability of remaining Afib-free in group 1 versus group 2 was 75% versus 96% at 365 days, and 69% versus 91% at 600 days (P = 0.01). A prior history of Afib did not interact with EF when analyzed with a logistic regression analysis. Conclusion: After an AFL ablation, the incidence of Afib is increased, and the probability of remaining free of Afib is decreased, when severe LVSD is present, independent of a prior history of Afib. This finding may have implications for optimal patient selection for AFL ablation, and the use of adjunctive therapies.

KW - Ablation

KW - Atrial fibrillation

KW - Congestive heart failure

KW - Electrophysiology - clinical

UR - http://www.scopus.com/inward/record.url?scp=33645262779&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645262779&partnerID=8YFLogxK

U2 - 10.1111/j.1540-8159.2005.00223.x

DO - 10.1111/j.1540-8159.2005.00223.x

M3 - Article

C2 - 16221263

AN - SCOPUS:33645262779

VL - 28

SP - 1055

EP - 1059

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 10

ER -