PREVALENCE OF IC COMMON-TYPE ATRIAL FLUTTER AND COMBINED EFFICACY OF RADIOFREQUENCY ISTHMUS ABLATION AND CHRONIC ANTIARRHYTHMIC DRUG TREATMENT IN PATIENTS WITH ATRIAL FIBRILLATION

Aims. The purpose of this study was to eval-uate the clinical outcome in patients with recur-rent atrial fibrillation (AF) and drug-related typical atrial flutter (AFL) undergoing cavotri-cuspid isthmus ablation. Methods. The study population consisted of 53 consecutive patients (36 men, 17 women, mean age 61 ± 11 years) with recurrent AF (paroxys-mal 62%, persistent 21%, paroxysmal and per-sistent 17%) and typical AFL while receiving class IC (79%) or class III (21%) antiarrhythmic drugs. All the patients underwent successful cavotricuspid isthmus ablation and continued the preexisting antiarrhythmic drug treatment. Results.Within the first month after the pro-cedure, AFL recurred in 4 patients who were successfully re-ablated. During a mean follow-up of 14 ± 9 months, AF recurred in 29 patients (55%), paroxysmal in 26, and persistent in 3. In these patients, however, the incidence (23 ± 44 episodes per year before ablation vs 6 ± 5 episodes per year after ablation, respectively, p = 0.02) was significantly lower compared to the year pre-ceding the ablation. Moreover, compared with the pre-ablation period, fewer patients needed hos-pitalization for arrhythmic problems (50 vs 12%, p = 0.001) and electrical cardioversion (28 vs 2%, p = 0.001). Overall, 88 % of the patients had an improvement in quality of life, 10 % no change, and 2 % had a worsening. One patient had a fatal stroke. Conclusions. In patients with recurrent AF and typical AFL related to class IC and III antiar-rhythmic drugs, cavotricuspid isthmus ablation and continuation of drug treatment eliminate AFL and reduce AF recurrences. As a conse-quence, a clinical benefit is observed