Purpose

Based on the high rate of coexisting atrial fibrillation (AF) and atrial flutter (AFL), prophylactic cavotricuspid isthmus ablation (CTIA) adjunctive to AF ablation has recently been attempted in patients with AF and without AFL. The present study aimed to determine the rates of AFL occurrence and CTI reconduction after performing CTI ablation adjunctive to AF ablation.

Methods

We analyzed the data of 3833 consecutive patients with AF, who underwent prophylactic CTIA with AF ablation between 2009 and 2020.

Results

In all patients, CTIA and AF ablations were successful. Clinical AFL occurred in seven patients (0.18%, 7/3,833), and the observed rate was lower than those reported for cases of AF ablation without CTIA and for those of CTIA for pure AFL. A second ablation was needed in 745 patients at a median of 253 days (25 and 75 percentiles, 116 and 775 days) after the first ablation. In 12.1% (90/745) of the patients, CTI reconduction was observed. The reconduction rate was lower than that previously reported for CTIA for pure AFL.

Conclusions

The present retrospective study found acceptably low rates of clinical AFL occurrence and CTI reconduction following prophylactic CTIA performed with AF ablation, which was supported by the findings obtained after performing a comparison of the rates with those of other ablations (AF ablation only and CTIA for pure AFL). Considering the high correlation between AF and AFL, the present study provided information regarding the efficacy of adjunctive CTIA.

中文翻译：

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房颤消融期间进行预防性峡部消融后心房扑动发生率和三尖瓣峡部再传导：一项临床研究、回顾和与先前发现的比较

目的

基于高并发心房颤动 (AF) 和心房扑动 (AFL) 的发生率，最近已尝试在 AF 和无 AFL 的患者中结合 AF 消融进行预防性三尖瓣峡部消融 (CTIA)。本研究旨在确定在 AF 消融的辅助下进行 CTI 消融后 AFL 的发生率和 CTI 再传导率。

方法

我们分析了 2009 年至 2020 年期间接受预防性 CTIA 和 AF 消融的 3833 名连续 AF 患者的数据。

结果

在所有患者中，CTIA 和 AF 消融均成功。临床 AFL 发生在 7 例患者中（0.18%，7/3,833），观察率低于报告的无 CTIA 的 AF 消融病例和 CTIA 治疗纯 AFL 的病例。745 名患者在第一次消融后的中位数为 253 天（25 和 75 个百分位数，116 和 775 天）需要进行第二次消融。在 12.1% (90/745) 的患者中，观察到 CTI 再传导。再传导率低于先前报道的纯 AFL 的 CTIA。

结论

本回顾性研究发现，在使用 AF 消融进行预防性 CTIA 后，临床 AFL 发生率和 CTI 再传导率较低，这一点得到了与其他消融（仅 AF 消融和 CTIA 纯AFL)。考虑到 AF 和 AFL 之间的高度相关性，本研究提供了有关辅助 CTIA 疗效的信息。