Abstract 17452: Inter-atrial Conduction Time Can Predict New-onset Atrial Fibrillation After Radiofrequency Ablation of Isolated, Typical Atrial Flutter

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ryuta Henmi ◽  
Koichiro Ejima ◽  
Daigo Yagishita ◽  
Yuji Iwanami ◽  
Moria Shoda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Atrial Flutter ◽  
Cox Regression ◽  
P Wave ◽  
Conduction Delay ◽  
Conduction Time ◽  
Intracardiac Electrogram ◽  
History Of ◽  
New Onset

Introduction: Previous studies showed inter-atrial conduction delay (IACT) is an important electrophysiological factor predicting atrial fibrillation (AF) after successful atrial flutter (AFL) ablation. To the best of our knowledge, there has no previous study regarding the prognostic value of IACT as a predictor of new-onset AF after AFL ablation without AF history. Hypothesis: The purpose of this study was to determine the incidence and predictors of new-onset AF after Radiofrequency ablation (RFA) of isolated AFL in a retrospective cohort study. Methods: This study included consecutive patients who underwent successful RFA of isolated, typical AFL from 2004 to 2012. Patients with any history of AF prior to AFL ablation were excluded. IACT was defined as the interval from the onset of P-wave in 12-lead electrocardiogram to atrial intracardiac electrogram at the distal coronary sinus catheter. Results: Eighty patients were included in this study. During a mean follow-up 3.4±2.6 years after successful AFL ablation, 22 patients (27.5%) developed new-onset AF. A Cox regression multivariate analysis demonstrated that IACT was the independent predictor of new-onset AF after AFL ablation (odds ratio: 13.3; 95% confidence interval: 1.36-152.5; p=0.0255). IACT was accurate in predicting new-onset AF (AUC=0.70). The optimal cut-off point of IACT for predicting new-onset AF was ≧120ms, with a sensitivity of 0.476 and a specificity of 0.898. Kaplan-Meier curves showed that new-onset AF after AFL ablation was significantly higher in the patients with IACT ≧120ms compared to the patients with IACT< 120ms (p=0.0016). Conclusions: IACT is an independent risk factor for new-onset AF after AFL ablation without a history of AF.

scholarly journals ECG Predictors for New-Onset Atrial Fibrillation Within a Year After Radiofrequency Ablation of Counterclockwise-Rotating Atrial Flutter

2021 ◽  
Vol 8 ◽  
Author(s):  
Hailei Liu ◽  
Zhoushan Gu ◽  
Chao Zhu ◽  
Mingfang Li ◽  
Jincheng Jiao ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Atrial Flutter ◽  
P Wave ◽  
Negative Component ◽  
Typical Atrial Flutter ◽  
History Of ◽  
Electrocardiographic Parameters ◽  
Onset Atrial Fibrillation ◽  
New Onset

Background: New-onset atrial fibrillation (AF) after ablation of typical atrial flutter (AFL) is not rare. This study aimed to investigate the predictive value of electrocardiographic parameters on new-onset AF post-typical AFL ablation.Methods: A total of 158 consecutive patients (79.1% males, mean age 57.8 ± 14.3 years) with typical AFL were enrolled between January 2012 and August 2017 in this single-center study. Patients with a history of AF before ablation were excluded. ECGs during sinus rhythm (SR) and AFL were collected. The duration of the negative component of flutter wave in lead II (DFNII), proportion of the DFNII of the total circle length of AFL (DFNII%), amplitude of the negative component of flutter wave in lead II (AFNII), duration (DPNV1), and amplitude (APNV1) of negative component of the P wave in lead V1, and P wave duration in lead II (DPII) during sinus rhythm were measured.Results: During a median follow-up of 26.9 ± 11.8 months, 22 cases (13.9%) developed new-onset AF. DFNII was significantly longer in patients with new-onset AF compared to patients without AF (114.7 ± 29.6 ms vs. 82.7 ± 12.8 ms, p &lt; 0.0001). AFNII was significantly lower (0.118 ± 0.034 mV vs. 0.168 ± 0.051 mV, p &lt; 0.0001), DPII (144.21 ± 23.77 ms vs. 111.46 ± 14.19 ms, p &lt; 0.0001), and DPNV1 was significantly longer (81.07 ± 16.87 ms vs. 59.86 ± 14.42 ms, p &lt; 0.0001) in patients with new-onset AF. In the multivariate analysis, DFNII [odds ratio (OR), 1.428; 95% CI, 1.039–1.962; p = 0.028] and DPII (OR, 1.429; 95% CI, 1.046–1.953; p = 0.025) were found to be independently associated with new-onset AF after typical AFL ablation.Conclusion: Parameters representing left atrial activation time under both the SR and AFL were independently associated with new-onset AF post-typical AFL ablation and may be useful in risk prediction, which needs to be confirmed by further prospective studies.

scholarly journals Risk of New-Onset Atrial Fibrillation Post-cavotricuspid Isthmus Ablation in Typical Atrial Flutter Without History of Atrial Fibrillation

2021 ◽  
Vol 12 ◽  
Author(s):  
Jia-hui Li ◽  
Hai-yang Xie ◽  
Yan-qiao Chen ◽  
Zhong-jing Cao ◽  
Qing-hui Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Cavotricuspid Isthmus ◽  
Typical Atrial Flutter ◽  
Obstructive Sleep ◽  
History Of ◽  
New Onset

Aims: The aim was to describe the incidence of atrial fibrillation (AF) after cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) without history of AF and to identify risk factors for new-onset AF after the procedure.Methods: A total of 191 patients with typical AFL undergoing successful CTI ablation were enrolled. Patients who had history of AF, structural heart disease, cardiac surgery, or ablation or who received antiarrhythmic drug after procedure were excluded. Clinical and electrophysiological data were collected.Results: There were 47 patients (24.6%) developing new AF during a follow-up of 3.3 ± 1.9 years after CTI ablation. Receiver operating characteristic (ROC) curves indicated that the cut-off values of left atrial diameter (LAD) and CHA2DS2-VASc score were 42 mm and 2, with area under the curve of 0.781 and 0.550, respectively. The multivariable Cox regression analysis revealed that obstructive sleep apnea (OSA) [hazard ratio (HR) 3.734, 95% confidence interval (CI) 1.470–9.484, P = 0.006], advanced interatrial block (aIAB) (HR 2.034, 95% CI 1.017–4.067, P = 0.045), LAD &gt; 42 mm (HR 2.710, 95% CI 1.478–4.969, P = 0.001), and CHA2DS2-VASc score &gt; 2 (HR 2.123, 95% CI 1.118–4.034, P = 0.021) were independent risk factors of new-onset AF.Conclusion: A combination of OSA, aIAB, LAD &gt; 42 mm, and CHA2DS2-VASc &gt; 2 was a strongly high risk for new-onset AF after ablation for typical AFL, and it had significance in postablation management in clinical practice.

P2463Advanced interatrial block is a surrogate for left atrial strain reduction which predicts atrial fibrillation and stroke

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Lacalzada Almeida ◽  
V Armarnani Armarnani ◽  
J Garcia-Niebla ◽  
M M Izquierdo-Gomez ◽  
R Elosua ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Left Atrial ◽  
Cox Regression ◽  
Imaging Techniques ◽  
P Wave ◽  
Control Group ◽  
End Point ◽  
Interatrial Block ◽  
New Onset

Abstract Background The association between advanced interatrial block (aIAB) and atrial fibrillation (AF) is known as “Bayes' Syndrome”. There is little information on the prognostic role that new speckle tracking echocardiographic (STE) imaging techniques could play in it. Purpose We have examined the relationship between left atrial (LA) STE and the prediction of new-onset AF and/or stroke in IAB patients. Methods Observational study with 98 outpatients: 55 (56.2%) controls with normal ECG, 21 (21.4%) with partial IAB (pIAB) and 22 (22.4%) with aIAB. The end-point was new-onset AF, ischemic stroke, and the composite of both. Results During a mean follow-up of 1.9 (1.7–2.3) years, 20 patients presented the end-point (18 new-onset AF and 2 strokes): 8 (14.5%) in the control group, 3 (14.3%) in pIAB and 9 (40.9%) in aIAB, p=0.03. In multivariable comprehensive Cox regression analyses, a decrease of strain rate during the booster pump function phase (SRa) was the only variable independently related to the appearance in the evolution of the end-point, in the first model (age, P wave duration and SRa): HR 19.9 (95% CI, 3.12–127.5), p=0.002 and in the second (age, presence of aIAB and SRa): HR 24.2 (95% CI, 3.15–185.4), p=0.002. Conclusions In patients with IAB, a decrease in absolute value of LA SRa with STE predicts new-onset AF and ischemic stroke. Acknowledgement/Funding None

Abstract 13474: Incremental Value of Left Atrial Conduction Time for Predicting Atrial Fibrillation in Patients Receiving Cardiac Pacing

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Makoto Saito ◽  
Kazuaki Negishi ◽  
Wojciech Kosmala ◽  
Gerry Kaye ◽  
Thomas H Marwick
Keyword(s):  
Atrial Fibrillation ◽  
Pacemaker Implantation ◽  
Cardiac Pacing ◽  
P Wave ◽  
Volume Index ◽  
Time Interval ◽  
Conduction Time ◽  
Chads2 Score ◽  
Incremental Value ◽  
New Onset

Background: Atrial fibrillation (AF) is a relatively common complication of cardiac pacing. Prolonged LA electromechanical conduction time (EMT) has been proposed for prediction of new- onset AF. We sought to investigate the incremental benefit of EMT for predicting AF over conventional predictors in pts undergoing pacing. Methods: We prospectively followed 127 pts with preserved ejection fraction, absence of chronic or known paroxismal AF, and a pacemaker implantation because of atrioventricular block in the PROTECT-PACE trial for 2 years. Reliable recognition of AF episodes was based on pacemaker monitoring. Echocardiography was performed just after the implantation. EMT was measured as the time interval from the onset of the P wave to the peak of the late diastolic wave from the septal and lateral mitral annulus on tissue Doppler echocardiography. We also assessed LA volume index (LAVI) and CHADS2 score. Results: 24 patients (19%) had new onset AF. Septal EMT was significantly longer in pts with AF than that in pts without AF (130±31 vs 112±31 ms, p=0.01). Larger LAVI and prolonged septal EMT were significantly associated with AF. In sequential logisitic models, LAVI added to the model power of CHADS2 score, and the model based on CHADS2 score and LAVI was significantly improved by adding septal EMT (Figure). Conclusion: EMT provides incremental value over the conventional risks for predicting a first episode of AF in patients receiving cardiac pacing.

Risk of new-onset atrial fibrillation and stroke after radiofrequency ablation of isolated, typical atrial flutter

Heart Rhythm ◽  
2014 ◽  
Vol 11 (11) ◽  
pp. 1884-1889 ◽  
Author(s):  
Jessica Voight ◽  
Mehmet Akkaya ◽  
Porur Somasundaram ◽  
Rehan Karim ◽  
Salimah Valliani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Atrial Flutter ◽  
Typical Atrial Flutter ◽  
Onset Atrial Fibrillation ◽  
New Onset

scholarly journals Assessment of left atrial electro-mechanical delay to predict atrial fibrillation in hypertrophic cardiomyopathy

2020 ◽  
Author(s):  
Catherina Tjahjadi ◽  
Yasmine L Hiemstra ◽  
Pieter van der Bijl ◽  
Stephan M Pio ◽  
Marianne Bootsma ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Tissue Doppler ◽  
P Wave ◽  
Doppler Imaging ◽  
Conduction Time ◽  
Atrial Conduction Time ◽  
New Onset

Abstract Aims Atrial fibrillation (AF) is frequently observed in hypertrophic cardiomyopathy (HCM) and is associated with poor clinical outcome. Total atrial conduction time, estimated by tissue Doppler imaging (TDI), the so-called PA-TDI duration, reflects the left atrial (LA) structural and electrical remodelling. The aim of this study was to evaluate the association between PA-TDI and new-onset AF in patients with HCM. Methods and results From a large cohort of patients with HCM, 208 patients (64% male, mean age 53 ± 14 years) without AF were selected. PA-TDI duration was measured from the onset P wave on electrocardiogram to the peak A′ wave of the lateral LA wall using TDI. The incidence of new-onset AF was 20% over a median follow-up of 7.3 (3.5–10.5) years. Patients with incident AF had longer PA-TDI duration when compared with patients without AF (133.7 ± 23.0 vs. 110.5 ± 30.0 ms, P &lt; 0.001). PA-TDI duration was independently associated with new-onset AF (hazard ratio: 1.03, 95% confidence interval: 1.01–1.05, P &lt; 0.001). Conclusion Prolonged PA-TDI duration was independently associated with new-onset AF in patients with HCM. This novel parameter could be useful to risk-stratify patients with HCM who are at risk of having AF.

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