Purpose

The incidence of atrial flutter following radiofrequency ablation of supraventricular tachycardias is poorly understood. Ablation of atrioventricular nodal reentry tachycardia may place patients at risk of flutter because ablation of the slow pathway is in close proximity to the cavotricuspid isthmus. This study aims to evaluate the risk of atrial flutter following ablation of atrioventricular nodal reentry tachycardia relative to ablation of other supraventricular tachycardias.

Methods

A single-center retrospective analysis was completed for all supraventricular tachycardia ablations performed between July 2006 and July 2016. Patient and procedural details were collected for 544 patients who underwent atrioventricular nodal reentry tachycardia ablation (n = 342), atrioventricular reentry tachycardia ablation (n = 125), or atrial tachycardia ablation (n = 60). Follow-up for flutter after ablation of their incident arrhythmia was assessed.

Results

Patients who underwent atrioventricular nodal reentry tachycardia ablation were more likely to develop CTI-dependent flutter than patients who underwent ablation of other supraventricular tachycardias (4.97% vs. 0%; p = 0.002). Compared with patients who did not develop flutter, patients who developed flutter after atrioventricular nodal reentry tachycardia ablation were more likely to have undergone ablation of atypical atrioventricular nodal reentry tachycardia (11.8% vs. 2.15%; p = 0.016).

Conclusions

We identified an association between atrioventricular nodal reentry tachycardia ablation and development of CTI-dependent atrial flutter. This finding may have implications for the management and follow-up after atrioventricular nodal reentry tachycardia ablation.

中文翻译：

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慢通路消融后三尖瓣峡部心房扑动的发生率增加

目的

对室上性心动过速射频消融后心房扑动的发生率知之甚少。房室结折返性心动过速的消融可能会使患者面临房颤的风险，因为慢速通路的消融靠近三尖瓣峡部。本研究旨在评估消融房室结折返性心动过速与消融其他室上性心动过速后发生房扑的风险。

方法

对 2006 年 7 月至 2016 年 7 月期间进行的所有室上性心动过速消融完成了单中心回顾性分析。 收集了 544 名接受房室结折返性心动过速消融（n  = 342）、房室折返性心动过速消融（n  = n = 125) 或房性心动过速消融术 ( n  = 60)。评估了他们发生的心律失常消融后扑动的随访情况。

结果

接受房室结折返性心动过速消融的患者比接受其他室上性心动过速消融的患者更容易发生 CTI 依赖性扑动（4.97% 对 0%；p  = 0.002）。与未发生扑动的患者相比，房室结折返性心动过速消融后发生扑动的患者更有可能接受非典型房室结折返性心动过速消融（11.8% vs. 2.15%；p  = 0.016）。

结论

我们确定了房室结折返性心动过速消融与 CTI 依赖性心房扑动的发展之间的关联。这一发现可能对房室结折返性心动过速消融后的管理和随访有影响。