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Long term follow up of radiofrequency catheter ablation of atrial flutter: clinical course and predictors of atrial fibrillation occurrence
  1. E Bertaglia1,
  2. F Zoppo1,
  3. A Bonso2,
  4. A Proclemer3,
  5. R Verlato4,
  6. L Corò5,
  7. R Mantovan6,
  8. D D’Este1,
  9. F Zerbo1,
  10. P Pascotto1,
  11. on behalf of the Northeastern Italian Study on Atrial Flutter Ablation Investigators
  1. 1Departments of Cardiology, Ospedale Civile, Mirano, Italy
  2. 2Ospedale Umberto I, Mestre, Italy
  3. 3Ospedale S Maria della Misericordia, Udine, Italy
  4. 4Ospedale Civile, Camposampiero, Italy
  5. 5Ospedale Civile, Conegliano, Italy
  6. 6Ospedale Ca’Foncello, Treviso, Italy
  1. Correspondence to:
    Dr E Bertaglia
    Via Mariutto, 13, 30135–Mirano (VE), Italy;


Objectives: To evaluate the time to onset and the predictors of atrial fibrillation (AF) during long term follow up of patients with typical atrial flutter (AFL) treated with transisthmic ablation.

Design: Prospective multicentre study.

Methods and results: 383 patients (75.4% men, mean (SD) age 61.7 (11.1) years) who underwent transisthmic ablation for typical AFL were investigated. In 239 patients (62.4%) AF was present before ablation. Ablation proved successful in 367 patients (95.8%). During a mean (SD) follow up of 20.5 (12.4) months, 41.5% of patients reported AF. The cumulative probability of postablation AF increased continuously as time passed: it was 22% at six months, 36% at one year, 50% at two years, 58% at three years, and 63% at four years.

Conclusions: AF occurred in a large proportion of patients after transisthmic catheter ablation of typical AFL. The occurrence of AF was progressive during follow up. Preablation AF, age < 65 years, and left atrial size > 50 mm are associated with postablation AF occurrence.

  • atrial flutter
  • atrial fibrillation
  • catheter ablation
  • AAD, antiarrhythmic drug
  • AF, atrial fibrillation
  • AFL, atrial flutter

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  • A complete list of investigators appears in the appendix.