ISSN 2149-2263 | E-ISSN 2149-2271
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Pre-Procedural Right Atrial Diameter May Predict the Development of Typical Atrial Flutter in Patients Undergoing Catheter Ablation for Atrial Fibrillation [Anatol J Cardiol]
Anatol J Cardiol. 2023; 27(12): 697-705 | DOI: 10.14744/AnatolJCardiol.2023.3324

Pre-Procedural Right Atrial Diameter May Predict the Development of Typical Atrial Flutter in Patients Undergoing Catheter Ablation for Atrial Fibrillation

Taner Ulus1, Aytuğ Al1, Fatih Enes Durmaz1, Emre Karakuş1, Ertuğrul Çolak2
1Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye
2Department of Biostatistics, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Türkiye

Background: Some patients undergoing catheter ablation for atrial fibrillation may develop typical atrial flutter on follow-up, and a second procedure for typical atrial flut-ter is often required in such patients. In this study, we aimed to define the variables asso-ciated with the development of typical atrial flutter after ablation.

Methods: One hundred fifty-nine patients who underwent catheter ablation for the first time due to atrial fibrillation and who did not have a previously documented atrial flutter were included in the study. Before ablation, baseline clinical features and echocardiographic parameters were recorded. At the 1st, 3rd, 6th, and 12th months after the procedure, and then annually, the patients were followed up for typical atrial flutter development.

Results: At a mean follow-up of 34.0 (14.0-50.0) months, typical atrial flutter developed in 21 (13.2%) patients. During the follow-up, right atrial diameter was greater in those who developed typical atrial flutter than those who did not [39.0 (38.0-43.0) vs. 36.0 (34.0-39.0) mm, P <.001]. A multiple Cox regression analysis showed that the right atrial diameter was the only independent predictor of typical atrial flutter development (hazard ratio = 1.12, 95% CI: 1.02-1.23, P =.021). A receiver operating characteristic analysis showed that the best cutoff for the right atrial diameter was 38.5 mm to predict typical atrial flutter development (area under the curve = 0.77, 95% CI: 0.67-0.86, sensitivity = 62%, specificity
= 75%, P <.001).

Conclusion: In patients undergoing catheter ablation for atrial fibrillation, a pre-procedural right atrial diameter measurement may predict typical atrial flutter development at follow-up. In particular, patients with a pre-procedural right atrial diameter ≥39 mm may be at a higher risk for developing typical atrial flutter in the future.

Keywords: Atrial fibrillation, atrial flutter, catheter ablation, right atrium

Taner Ulus, Aytuğ Al, Fatih Enes Durmaz, Emre Karakuş, Ertuğrul Çolak. Pre-Procedural Right Atrial Diameter May Predict the Development of Typical Atrial Flutter in Patients Undergoing Catheter Ablation for Atrial Fibrillation. Anatol J Cardiol. 2023; 27(12): 697-705

Corresponding Author: Taner Ulus, Türkiye
Manuscript Language: English


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