Heart Vessels and Transplantation (Mar 2024)
Ablation outcomes and quality of life in patients with atrial flutter and concomitant paroxysmal atrial fibrillation
Abstract
Objective: To compare ablation outcomes and quality of life (QoL) of patients with typical atrial flutter (AFL) and concomitant atrial fibrillation (AF) paroxysms after cavotricuspid isthmus (CTI) ablation alone or combined with pulmonary vein isolation. Methods: The single-center study included 43 patients with CTI-dependent AFL and paroxysmal AF. We compared QoL, clinical data concerning the course of arrhythmia recurrence in 18 (41.9%) patients with isolated CTI ablation versus 25 (58.1%) persons with both CTI ablation and pulmonary vein isolation (PVI) after one-year of follow-up. Results: The compared groups did not differ by gender, anthropometric parameters, and concomitant diseases. Patients from the group of isolated CTI ablation were older (64 [54-68] versus 54 [52-60] years, p = 0.006). During the one-year follow-up, there were no recurrences of AFL in the study patients. Symptomatic AF paroxysms were more frequent in the group with isolated CTI ablation (5 [27.8%] vs. 1 [4.0%], p = 0.038). Paroxysms of non-sustained atrial tachycardia were often recorded in both groups during Holter ECG monitoring (11 [61.1%] vs. 10 [40.0%]); for paroxysmal AF, the numbers were 13 (72.2%) vs. 9 (36.0%). Regardless of the extent of the intervention, there were significant QoL improvements in both groups of patients: the AFEQT Total score before the intervention was 53.2 (40.7-62.0) and 51.7 (42.5-59.3) versus 81.4 (75.9-88.9) and 85.6 (81.2-91.6) after the intervention, respectively (p < 0.05). Conclusions: The frequency of symptomatic AF recurrences was lower in the group of combined intervention. In patients with typical AFL and concomitant paroxysmal AF, both CTI ablation as isolated procedure or combined with pulmonary vein isolation improve quality of life parameters.
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