Catheter ablation and atrial fibrillation: the days and months after

Backround: radiofrequency (RF) catheter ablation for atrial fibrillation (AF) is a promising therapeutic alternative for patients with this arrhythmia.After successful RF ablation for typical atrial flutter (AFL) atrial arrhythmias, especially AF, occur.On the contrary after RF ablation for AF has become a problem AFL appearance.The aim of this study was to determine the incidence of AFL in patients, who underwent AF ablation.Methods: 91 patients (20 female, 54 4-9 years) with paroxysmal or persistent, drug-refractory AF were scheduled for catheter ablation for AE The procedures were performed using several methods: 1) with the support of circular mapping lasso catheter, 2) using electroanatomical mapping system CARTO or 3) combination of both previous methods with navigation by intracardiac echocardiography.Patients were divided into three groups: group I consisted of subjects, who underwent ablation of cavotricuspid isthmus (CTI) in preceding time before AF ablation.Group B included patients with ablation of both arrhythmias during one procedure and in group III were enroled cases, who developed AFL after ablation for AF.Results: in addition to AF ablation in 31 subjects (34%) also RF ablation of CTI was performed.In group I were included 9 patients, 2 developed recurrence of AFL and CTI ablation was repeated.Group II consisted of 20 subjects, no recurrence of AFL was detected.In 8 cases (group III) AFL appeared subsequently after ablation of AF, two patients have already underwent ablation of CTI and the rest of them will be scheduled for this procedure consecutively.Conclusion: in one third of patients with AF ablation developed typical AFL.In most cases ablation of CTI was performed during one procedure together with AF treatment.In 8 subjects AFL appeared newly after catheter ablation for AF.Ablation for AF is not able to prevent AFL.In order to prevent AFL incidence CTI ablation in all patients undergoing AF ablation should be considered.