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Shah AS, Ongtengco A, Qiao V, Chen Y, Diaz A, Hill M, Bhan A, Tofovic DS, Darbar D. Association Between Family History and Early-Onset Atrial Flutter Across Racial and Ethnic Groups. J Am Heart Assoc 2024; 13:e032320. [PMID: 38726902 DOI: 10.1161/jaha.123.032320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 04/17/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Genetic and familial contributions to early-onset atrial fibrillation are described primarily in individuals of European ancestry. However, the role of racial and familial contributions in the pathogenesis of early-onset atrial flutter (EOAFL) is unclear. METHODS AND RESULTS In this cross-sectional study, participants were enrolled prospectively from 2015 to 2021 in multiple academic centers with a diagnosis of atrial flutter (AFL) confirmed by ECG. EOAFL was defined as a diagnosis of AFL before age 66 years with no concomitant or previous diagnosis of atrial tachyarrhythmias. Family history was adjudicated through baseline questionnaires and direct family interviews about the diagnosis of atrial tachyarrhythmias, stroke, and cardiomyopathy. The primary exposure was a positive family history in first-degree relatives, and the primary outcome was the odds of EOAFL versus late-onset AFL. A total of 909 patients were enrolled. Participants with a positive family history of atrial tachyarrhythmias were younger, less likely to be of Black race, and more likely to have EOAFL. The adjusted odds ratio (OR) for EOAFL in those with a positive family history was 1.8 (95% CI, 1.1-3.0). There was an increased odds of EOAFL in those of Black race (OR, 2.1 [95% CI, 1.4-3.2]), alcohol use (OR, 1.6 [95% CI, 1.0-2.6]), and obstructive sleep apnea (OR, 1.9 [95% CI, 1.0-3.4]). Use of cardioselective β blockers or calcium channel blockers before the diagnosis of AFL were associated with a lower odds of EOAFL (OR, 0.5 [95% CI, 0.2-0.9]). CONCLUSIONS These findings suggest a potentially hereditary predisposition to EOAFL across race and ethnicity, warranting further study of the genetic contributions to AFL.
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Affiliation(s)
- Anish S Shah
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
- Jesse Brown Veterans Administration Medical Center Chicago IL
| | - Ana Ongtengco
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
| | - Victor Qiao
- Division of Academic Internal Medicine, Department of Medicine University of Illinois Chicago Chicago IL
| | - Yining Chen
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
| | - Annette Diaz
- College of Liberal Arts and Sciences, University of Illinois Chicago Chicago IL
| | - Michael Hill
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
- Jesse Brown Veterans Administration Medical Center Chicago IL
| | | | - David S Tofovic
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
- College of Liberal Arts and Sciences, University of Illinois Chicago Chicago IL
- Center for Cardiovascular Research University of Illinois Chicago Chicago IL
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine University of Illinois Chicago Chicago IL
- College of Liberal Arts and Sciences, University of Illinois Chicago Chicago IL
- Center for Cardiovascular Research University of Illinois Chicago Chicago IL
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He J, Liu S, Yang C, Wei Y. Value of baseline characteristics in the risk prediction of atrial fibrillation. Front Cardiovasc Med 2023; 10:1068562. [PMID: 36818333 PMCID: PMC9928725 DOI: 10.3389/fcvm.2023.1068562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Atrial fibrillation (AF) is prone to heart failure and stroke. Early management can effectively reduce the stroke rate and mortality. Current clinical guidelines screen high-risk individuals based solely on age, while this study aims to explore the possibility of other AF risk predictors. Methods A total of 18,738 elderly people (aged over 60 years old) in Chinese communities were enrolled in this study. The baseline characteristics were mainly based on the diagnosis results of electrocardiogram (ECG) machine during follow up, accompanied by some auxiliary physical examination basic data. After the analysis of both independent and combined baseline characteristics, AF risk predictors were obtained and prioritized according to the results. Independent characteristics were studied from three aspects: Chi-square test, Mann-Whitney U test and Cox univariate regression analysis. Combined characteristics were studied from two aspects: machine learning models and Cox multivariate regression analysis, and the former was combined with recursive feature elimination method and voting decision. Results The resulted optimal combination of risk predictors included age, atrial premature beats, atrial flutter, left ventricular hypertrophy, hypertension and heart disease. Conclusion Patients diagnosed by short-time ECG machines with the occurrence of the above events had a higher probability of AF episodes, who are suggested to be included in the focus of long-term ECG monitoring or increased screening density. The incidence of risk predictors in different age ranges of AF patients suggests differences in age-specific patient management. This can help improve the detection rate of AF, standardize the management of patients, and slow down the progression of AF.
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Affiliation(s)
- Jiacheng He
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Sen Liu
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China
| | - Cuiwei Yang
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai, China,Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai, Shanghai, China,*Correspondence: Cuiwei Yang,
| | - Yong Wei
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Yong Wei,
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Uniat J, Silka MJ. Risk assessment of pre-excitation: Atrial fibrillation versus atrial flutter. HeartRhythm Case Rep 2022; 9:31-33. [PMID: 36685684 PMCID: PMC9845542 DOI: 10.1016/j.hrcr.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jonathan Uniat
- Address reprint requests and correspondence: Dr Jonathan Uniat, Children’s Hospital Los Angeles, 4650 Sunset Blvd, MS #34, Los Angeles, CA 90027.
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Liao W, Xu L, Pan Y, Wei J, Wang P, Yang X, Chen M, Gao Y. Association of atrial arrhythmias with thrombospondin-1 in patients with acute myocardial infarction. BMC Cardiovasc Disord 2021; 21:507. [PMID: 34670505 PMCID: PMC8527677 DOI: 10.1186/s12872-021-02322-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/14/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Atrial remodeling is the main developmental cause of atrial arrhythmias (AA), which may induce atrial fibrillation, atrial flutter, atrial tachycardia, and frequent premature atrial beats in acute myocardial infarction (AMI) patients. Thrombospondin-1 (TSP-1) has been shown to play an important role in inflammatory and fibrotic processes, but its role in atrial arrhythmias is not well described. The purpose of this study was to investigate the role of TSP-1 in AMI patients with atrial arrhythmias. METHODS A total of 219 patients with AMI who underwent percutaneous coronary intervention and with no previous arrhythmias were included. TSP-1 were analyzed in plasma samples. Patients were classified into 2 groups, namely, with and without AA during the acute phase of MI. Continuous electrocardiographic monitoring was used for AA diagnosis in hospital. RESULTS Twenty-four patients developed AA. Patients with AA had higher TSP-1 levels (29.01 ± 25.87 μg/mL vs 18.36 ± 10.89 μg/mL, p < 0.001) than those without AA. AA patients also tended to be elderly (65.25 ± 9.98 years vs 57.47 ± 10.78 years, p < 0.001), had higher Hs-CRP (39.74 ± 43.50 mg/L vs 12.22 ± 19.25 mg/L, p < 0.001) and worse heart function. TSP-1 (OR 1.033; 95% CI 1.003-1.065, p = 0.034), Hs-CRP (OR 1.023; 95% CI 1.006-1.041, p = 0.008), age (OR 1.067; 95% CI 1.004-1.135, p = 0.038) and LVDd (OR 1.142; 95% CI 1.018-1.282, p = 0.024) emerged as independent risk factors for AA in AMI patients. CONCLUSION TSP-1 is a potential novel indicator of atrial arrhythmias during AMI.
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Affiliation(s)
- Wenkai Liao
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Li Xu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yuxia Pan
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jie Wei
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Peijia Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xinchun Yang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Mulei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China. .,Department of Cardiology, Chaoyang Hospital, Capital Medical University, 8th Gongtinan Rd, Chaoyang District, Beijing, 100020, China.
| | - Yuanfeng Gao
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China. .,Department of Cardiology, Chaoyang Hospital, Capital Medical University, 8th Gongtinan Rd, Chaoyang District, Beijing, 100020, China.
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Ruipérez-Campillo S, Castrejón S, Martínez M, Cervigón R, Meste O, Merino JL, Millet J, Castells F. Non-invasive characterisation of macroreentrant atrial tachycardia types from a vectorcardiographic approach with the slow conduction region as a cornerstone. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105932. [PMID: 33485078 DOI: 10.1016/j.cmpb.2021.105932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Macroreentrant atrial tachyarrhythmias (MRATs) can be caused by different reentrant circuits. The treatment for each MRAT type may require ablation at different sites, either at the right or left atria. Unfortunately, the reentrant circuit that drives the arrhythmia cannot be ascertained previous to the electrophysiological intervention. METHODS A noninvasive approach based on the comparison of atrial vectorcardiogram (VCG) loops is proposed. An archetype for each group was created, which served as a reference to measure the similarity between loops. Methods were tested in a variety of simulations and real data obtained from the most common right (peritricuspid) and left (perimitral) macroreentrant circuits, each divided into clockwise and counterclockwise subgroups. Adenosine was administered to patients to induce transient AV block, allowing the recording of the atrial signal without the interference of ventricular signals. From the vectorcardiogram, we measured intrapatient loop consistence, similarity of the pathway to archetypes, characterisation of slow velocity regions and pathway complexity. RESULTS Results show a considerably higher similarity with the loop of its corresponding archetype, in both simulations and real data. We found the capacity of the vectorcardiogram to reflect a slow velocity region, consistent with the mechanisms of MRAT, and the role that it plays in the characterisation of the reentrant circuit. The intra-patient loop consistence was over 0.85 for all clinical cases while the similarity of the pathway to archetypes was found to be 0.85 ± 0.03, 0.95 ± 0.03, 0.87 ± 0.04 and 0.91 ± 0.02 for the different MRAT types (and p<0.02 for 3 of the 4 groups), and pathway complexity also allowed to discriminate among cases (with p<0.05). CONCLUSIONS We conclude that the presented methodology allows us to differentiate between the most common forms of right and left MRATs and predict the existence and location of a slow conduction zone. This approach may be useful in planning ablation procedures in advance.
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Affiliation(s)
- Samuel Ruipérez-Campillo
- ITACA Institute, Universitat Politècnica de València, Valencia, Spain; Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology (ETH), Zürich, Zürich, Switzerland; Department of Bioengineering and Aeroespace Engineering, Universidad Carlos III de Madrid, Madrid, Spain.
| | - Sergio Castrejón
- Unidad de Arritmias y Electrofisiología Robotizada, Hospital Universitario La Paz, IdiPaz, Universidad Autónoma, Madrid, Spain
| | - Marcel Martínez
- Unidad de Arritmias y Electrofisiología Robotizada, Hospital Universitario La Paz, IdiPaz, Universidad Autónoma, Madrid, Spain
| | - Raquel Cervigón
- Escuela Politécnica, Universidad de Castilla la Mancha, Cuenca, Spain
| | - Olivier Meste
- Université Cote d'Azur, CNRS, Lab. I3S, Sophia Antipolis, France
| | - José Luis Merino
- Unidad de Arritmias y Electrofisiología Robotizada, Hospital Universitario La Paz, IdiPaz, Universidad Autónoma, Madrid, Spain
| | - José Millet
- ITACA Institute, Universitat Politècnica de València, Valencia, Spain
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Herrold EJ, White AJ, Fox PR. ECG of the Month. J Am Vet Med Assoc 2021; 257:41-43. [PMID: 32538699 DOI: 10.2460/javma.257.1.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Guichard JB, Naud P, Xiong F, Qi X, L'Heureux N, Hiram R, Tardif JC, Cartier R, Da Costa A, Nattel S. Comparison of Atrial Remodeling Caused by Sustained Atrial Flutter Versus Atrial Fibrillation. J Am Coll Cardiol 2021; 76:374-388. [PMID: 32703507 DOI: 10.1016/j.jacc.2020.05.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Atrial flutter (AFL) and atrial fibrillation (AF) are associated with AF-promoting atrial remodeling, but no experimental studies have addressed remodeling with sustained AFL. OBJECTIVES This study aimed to define the atrial remodeling caused by sustained atrial flutter (AFL) and/or atrial fibrillation (AF). METHODS Intercaval radiofrequency lesions created a substrate for sustained isthmus-dependent AFL, confirmed by endocavity mapping. Four groups (6 dogs per group) were followed for 3 weeks: sustained AFL; sustained AF (600 beats/min atrial tachypacing); AF superimposed on an AFL substrate (AF+AFLs); sinus rhythm (SR) with an AFL substrate (SR+AFLs; control group). All dogs had atrioventricular-node ablation and ventricular pacemakers at 80 beats/min to control ventricular rate. RESULTS Monitoring confirmed spontaneous AFL maintenance >99% of the time in dogs with AFL. At terminal open-chest study, left-atrial (LA) effective refractory period was reduced similarly with AFL, AF+AFLs and AF, while AF vulnerability to extrastimuli increased in parallel. Induced AF duration increased significantly in AF+AFLs and AF, but not AFL. Dogs with AF+AFLs had shorter cycle lengths and substantial irregularity versus dogs with AFL. LA volume increased in AF+AFLs and AF, but not dogs with AFL, versus SR+AFLs. Optical mapping showed significant conduction slowing in AF+AFLs and AF but not AFL, paralleling atrial fibrosis and collagen-gene upregulation. Left-ventricular function did not change in any group. Transcriptomic analysis revealed substantial dysregulation of inflammatory and extracellular matrix-signaling pathways with AF and AF+ALs but not AFL. CONCLUSIONS Sustained AFL causes atrial repolarization changes like those in AF but, unlike AF or AF+AFLs, does not induce structural remodeling. These results provide novel insights into AFL-induced remodeling and suggest that early intervention may be important to prevent irreversible fibrosis when AF intervenes in a patient with AFL.
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Affiliation(s)
- Jean-Baptiste Guichard
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada; Department of Cardiology, University Hospital of Saint-Étienne, University Jean Monnet, Saint-Étienne, France
| | - Patrice Naud
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Feng Xiong
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Xiaoyan Qi
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Nathalie L'Heureux
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Roddy Hiram
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Jean-Claude Tardif
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Raymond Cartier
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada
| | - Antoine Da Costa
- Department of Cardiology, University Hospital of Saint-Étienne, University Jean Monnet, Saint-Étienne, France
| | - Stanley Nattel
- Department of Medicine and Research Center Montreal Heart Institute and Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology and Therapeutics, McGill University Montréal, Montréal, Québec, Canada; Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany; IHU LIRYC and Fondation Bordeaux Université, Bordeaux, France.
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8
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Manolis TA, Manolis AA, Apostolopoulos EJ, Papatheou D, Melita H, Manolis AS. Cardiac arrhythmias in pregnant women: need for mother and offspring protection. Curr Med Res Opin 2020; 36:1225-1243. [PMID: 32347120 DOI: 10.1080/03007995.2020.1762555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiac arrhythmias are the most common cardiac complication reported in pregnant women with and without structural heart disease (SHD); they are more frequent among women with SHD, such as cardiomyopathy and congenital heart disease (CHD). While older studies had indicated supraventricular tachycardia as the most common tachyarrhythmia in pregnancy, more recent data indicate an increase in the frequency of arrhythmias, with atrial fibrillation (AF) emerging as the most frequent arrhythmia in pregnancy, attributed to an increase in maternal age, cardiovascular risk factors and CHD in pregnancy. Importantly, the presence of any tachyarrhythmia during pregnancy may be associated with adverse maternal and fetal outcomes, including death. Thus, both the mother and the offspring need to be protected from such consequences. The use of antiarrhythmic drugs (AADs) depends on clinical presentation and on the presence of underlying SHD, which requires caution as it promotes pro-arrhythmia. In hemodynamically compromised women, electrical cardioversion is successful and safe to both mother and fetus. Use of beta-blockers appears quite safe; however, caution is advised when using other AADs, while no AAD should be used, if at all possible, during the first trimester when organogenesis takes place. Regarding the anticoagulation regimen in patients with AF, warfarin should be substituted with heparin during the first trimester, while direct oral anticoagulants are not indicated given the lack of data in pregnancy. Finally, for refractory arrhythmias, ablation and/or device implantation can be performed with current techniques in pregnant women, when needed, using minimal exposure to radiation. All these issues and relevant current guidelines are herein reviewed.
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Baman JR, Kaplan RM, Diaz CL, Peigh G, Bavishi AA, Trivedi A, Wasserlauf J, Chicos AB, Arora R, Kim S, Lin A, Verma N, Knight BP, Passman RS. Characterization of atrial flutter after pulmonary vein isolation by cryoballoon ablation. J Interv Card Electrophysiol 2020; 57:233-240. [PMID: 31102114 PMCID: PMC7025862 DOI: 10.1007/s10840-019-00560-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Pulmonary vein isolation (PVI) by cryoballoon ablation (CBA) has emerged as a commonly used technique for the treatment of atrial fibrillation. We sought to explore the incidence, risk factors for, and characterization of post-CBA-PVI atrial flutter. METHODS We analyzed a prospective registry of patients who underwent CBA-PVI at a single institution. We included patients with more than 3 months of follow-up data and excluded those with a history of cavotricuspid isthmus (CTI) ablation. Locations of post-CBA-PVI atrial flutters were determined by analysis of intracardiac electrograms and electroanatomic maps. RESULTS There were 556 patients included in the analysis. The mean age was 61.0 ± 10.6 years, 67.4% were male, the number of failed anti-arrhythmic medication trials was 1.2 ± 0.8, and the duration of atrial fibrillation pre-CBA was 54.3 ± 69.1 months. The 28-mm second-generation cryoballoon was used almost exclusively. Over a median follow-up time of 22.7 ± 17.9 months, 25 (4.5%) patients developed post-CBA-PVI atrial flutter after the 3-month blanking period. Of those 25 patients, 15 (60%) underwent subsequent ablation to eliminate the atrial flutter circuit, with 60% being CTI-dependent and the remainder left-sided (p value not significant). Risk factors for the development of atrial flutter included NYHA class ≥ 2 (OR 5.02, p < 0.001), presence of baseline bundle branch block (OR 4.33, p = 0.006), and left ventricular ejection fraction < 50% (OR 3.36, p = 0.007). CONCLUSIONS The rate of post-CBA-PVI atrial flutter is low after the blanking period even with medium-term follow-up. The origin of atrial flutter is equally divided between the right and left atria.
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Affiliation(s)
- Jayson R Baman
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Rachel M Kaplan
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Celso L Diaz
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Graham Peigh
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Aakash A Bavishi
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Amar Trivedi
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Jeremiah Wasserlauf
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Alexandru B Chicos
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | | | - Susan Kim
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Albert Lin
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Nishant Verma
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Bradley P Knight
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA
| | - Rod S Passman
- Division of Cardiology, Department of Medicine, and the Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, Northwestern University, 676 N St Claire Street; Suite 600, Chicago, IL, 60611, USA.
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Potapova KV, Nosov VP, Koroleva LY, Amineva NV. [Atrial Flutter: up-to-date Problem Evaluation with Clinical Positions]. ACTA ACUST UNITED AC 2020; 60:70-80. [PMID: 32245357 DOI: 10.18087/cardio.2020.1.n693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/29/2019] [Indexed: 11/18/2022]
Abstract
The review provides current ideas about the etiology and prevalence of atrial flutter (AF), mechanism and substrate of arrhythmogenesis, and principles of clinical and electrophysiological classification of this arrhythmia. Methods for conservative and surgical treatments of AF, including their comparative aspect, are described in detail. The review presented recent data on efficacy and potential risks of different approaches to reversing the arrhythmia. The authors indicated a need for early diagnosis and strict control of the sinus rhythm in AF, which would help a successful intervention not only to completely cure the existing arrhythmia but also to prevent other heart rhythm disorders, primarily atrial fibrillation.
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Affiliation(s)
| | - V P Nosov
- Privolzhsky Research Medical University
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