209: Incidence of atrial fibrillation in patients with atrial flutter before and after ablation according to the nature of associated heart disease

Radiofrequency (RF) ablation is a treatment of choice of typical atrial flutter (AFl). However the risk of atrial fibrillation (AF) is high. Heart disease (HD) presence may modify this risk. The purpose of the study was to look for the role of associated HD on previous history of AF and later occurrence of AF after AFl ablation.Methods965 patients, mean age 64±12, were consecutively referred for ablation of recurrent or poor-tolerated AFL. Clinical history, occurrence of AF, data of echocardiography was collected. Patients were followed from 3 months up to 10 years. Antiarrhythmic drugs were stopped after ablation except in patients with history of AF before ablation.ResultsHD was present in 744 patients (77%): hypertensive disease (HTD) (n=186), ischemic HD (IHD) (n=163), valvular HD (VHD) (n=113), dilated cardiomyopathy (DCM) (n= 87), respiratory failure (resp) (n=84), congenital HD (cong) (n=26), miscellaneous HD (n=59). Prior AF was more frequent in patients without HD (67%) than in patients with HD (26%)(p<0.0000). Differences were significant with all subgroups of HD except for patients with DCM (55%). Last patients differed significantly from all other subgroups of HD. During follow-up (3±3years) 40 patients without HD (22%), 115 with HD (18%) developed AF (NS). There were no differences among all subgroups of HD. Among patients with later AF, 15 without HD (8%); 70 with HD (10%) had no prior AF (NS). Among subgroups with HD, patients with cong HD had a higher risk of AF (28.5%) than patients without HD (10%)(p< 0.003) or patients with DCM (7%) (p