Arrhythmias & electrophysiology
Radiofrequency Catheter Ablation for Pulmonary Hypertension Patients with Atrial Flutter
Authors' conclusion
Repeat ablation was safe and feasible in patients with recurrent AFL and can maintain sinus rhythm. AFL recurrence was not associated with all-cause mortality, and patients with high PASP or IPAH were at higher risk for adverse outcomes.
Study context
- Population
- Patients with pulmonary hypertension (PH) and atrial flutter (AFL) undergoing radiofrequency catheter ablation (RFCA), April 2013–August 2021
- Participants
- 58 patients
- Outcome
- Effects of RFCA and predictors of all-cause mortality
- Follow-up
- Mean 33.8 months
Methodological detailsconsecutive patients, single-group
- Consecutive patients
- Single-group
Main finding
As reported in the abstract
mean follow-up 33.8 months
RFCA
- Sinus rhythm restored during RFCA
- 53 (91.4%)
- AFL recurrence
- 22
- Repeat RFCA
- 9
RFCA
Sinus rhythm restored during RFCA53 (91.4%)
AFL recurrence22
Repeat RFCA9
Hazard ratio (95% CI)P value
NT-proBNP
1.00024(1.00008–1.00041)
P = 0.004PASP
1.048(1.020–1.076)
P = 0.001IPAHvs PAH-CHD
7.720(1.437–41.483)
P = 0.017- Kaplan-Meier all-cause mortality, AFL recurrence vs no recurrence: no significant difference
- P = 0.851
Observational data: associations, not effects.
Further findings
Repeat RFCA patients: AFL recurrence and survival · median follow-up 34.6 months after last ablation
- No AFL recurrence after repeat RFCA; all survived
Pulmonary artery systolic pressure (PASP) for predicting all-cause mortality (ROC)
- AUC
- 0.708
Survival by PASP and PH type (Kaplan-Meier)
- Lower survival with higher PASP (≥110 mmHg) and idiopathic pulmonary arterial hypertension (IPAH)
Safety
| Outcome | Values |
|---|---|
| Procedure-related complications · during hospitalization or follow-up | RFCA 0 events |
Original publication
Radiofrequency Catheter Ablation for Pulmonary Hypertension Patients with Atrial Flutter. ESC Heart Fail. Published 10 January 2024. doi:10.
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