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Radiofrequency ablation of atrial flutter due to administration of class IC antiarrhythmic drugs for atrial fibrillation
- Source :
- The American Journal of Cardiology. 83:710-713
- Publication Year :
- 1999
- Publisher :
- Elsevier BV, 1999.
-
Abstract
- In selected patients, atrial fibrillation (AF) converts to atrial flutter (AFI) due to treatment with class IC antiarrhythmic drugs. In this study, we prospectively investigated the effects of AFI ablation and continuation of drug therapy in patients with AF who developed AFI due to long-term administration of class IC antiarrhythmic drugs. The study population consisted of 187 patients from an AF registry with paroxysmal AF who were orally treated with flecainide (n = 96) or propafenone (n = 91). Twenty-four patients (12.8%) developed AFI during the course of treatment. In 20 of these patients (10.7%), electrophysiologic study revealed typical AFI. These patients underwent radiofrequency ablation of AFI. Ablation failed in 1 patient. All patients continued preexisting drug treatment. Recurrence of AF was assessed by ambulatory Holter monitoring and serial questionnaires. During a mean follow-up of 11 +/- 4 months, the incidence of AF episodes was significantly lower in patients with a combined therapy (2.7 +/- 3.6 per year) than in control subjects with a sole drug treatment (7.8 +/- 9.2 per year, p0.05) and than before therapy (10.2 +/- 5.4 per year, p0.001). Subgroup analysis revealed that 7 patients (36.8%) remained symptom free with no evidence of atrial tachyarrhythmia. Eight additional patients (42.1%) had ongoing paroxysmal AF, however, with a significantly lower incidence of AF episodes than before therapy (2.3 +/- 1.6 per year vs 11.5 +/- 5.0 per year, p0.001). In the remaining 4 patients (14.7%), no beneficial effect of AFI ablation was found. It is concluded that in patients with AF who develop typical AFI due to administration of class IC antiarrhythmic agents, a combined therapy with catheter ablation of AFI and continuation of drug treatment is highly effective in reducing occurrence and duration of atrial tachyarrhythmias.
- Subjects :
- medicine.medical_specialty
Radiofrequency ablation
medicine.medical_treatment
Administration, Oral
Propafenone
Antiarrhythmic agent
law.invention
Electrocardiography
Recurrence
law
Surveys and Questionnaires
Internal medicine
Atrial Fibrillation
medicine
Humans
Prospective Studies
Registries
Flecainide
business.industry
Atrial fibrillation
medicine.disease
Ablation
Combined Modality Therapy
Treatment Outcome
Atrial Flutter
Anesthesia
Ambulatory
Catheter Ablation
Electrocardiography, Ambulatory
Cardiology
Cardiology and Cardiovascular Medicine
business
Anti-Arrhythmia Agents
Atrial flutter
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 00029149
- Volume :
- 83
- Database :
- OpenAIRE
- Journal :
- The American Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....5e830a372265c806ef3dfa35421a1a98