Journal Article

5. Atrial Tachycardia, Atrial Flutter & WPW Syndrome

P. Zambito, A. Talreja, S. Gundewar, J. Fisher, K. Ferrick, J. Gross, S. Kim and E. Palma

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S8-S8
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI:
5. Atrial Tachycardia, Atrial Flutter & WPW Syndrome

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Severe left ventricular systolic dysfunction (LVSD) is associated with a high incidence of atrial fibrillation (Afib). Afib that occurs after a successful atrial flutter (AFL) ablation may negate the potential benefits of the ablation. We hypothesized that severe LVSD increases the incidence of post-ablation Afib despite a successful AFL ablation.


90 consecutive patients with LVSD who underwent ablation for AFL at Montefiore Medical Center from August 2001 to January 2005 were classified according to the severity of LVSD. Group 1 (n = 36) consisted of patients with EF ≤ 35%, and group 2 (n = 54) consisted of patients with EF 36-55%. There were no statistically significant differences in baseline patient characteristics between the 2 groups.


During a mean follow up of 350 days, Afib occurred in 31% (n = 11; 8 with prior history of AFib) in group 1, and 7.4% (n = 4; all with prior history of Afib) in group 2. Cumulative probability of remaining Afib-free in group 1 vs. group 2 was 75% vs. 96% at 365 days, and 69% vs. 91% at 600 days (p = 0.01). A prior history of Afib did not interact with EF when analyzed with a logistic regression analysis. Figure 1

Kaplan-Meier estimates of the time to atrial fibrillation occurrence post-ablation in patients with EF ≤ 35% (solid line) and EF 36-55% (dotted line).


After an AFL ablation, severe LVSD increases the incidence of AFib (31% vs. 7.4%, p = 0.004) independent of a prior history of Afib. This finding may have implications for optimal patient selection for AFL ablation, and the use of adjunctive therapies.

Journal Article.  0 words.  Illustrated.

Subjects: Cardiovascular Medicine

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