Atrial flutter ablation success rate9/11/2023 ![]() There have been multiple publications on the ablation of cavotricuspid isthmus-dependent arrhythmias with or without targeting additional substrate in the right atrium late after cardiac surgery (i.e., “incisional flutter”), however, to the best of our knowledge, ablation therapy as a management option for typical flutter early after cardiac surgery has not been previously described. In part, due to the anatomically fixed structures contributing to the reentrant circuit, typical atrial flutter has a considerable recurrence rate when managed conservatively. Conventional management options include electrical or pharmacological cardioversion, rate control, or antiarrhythmic drug therapy. Management strategies are usually adopted from atrial fibrillation patients, however few data exist on dedicated management of atrial flutter in this setting. Whereas in postoperative atrial fibrillation, triggering and maintenance of the arrhythmia is influenced by multiple conditions related to surgery like fluid imbalances, inflammation, sympathetic activation and electrolyte shift, typical postoperative atrial flutter exhibits the same flutter circuit as in a non-postoperative setting. Atrial flutter is found less commonly after cardiac surgery where it can occur as an isolated or predominant arrhythmia. The most commonly found arrhythmia is atrial fibrillation. Postoperative supraventricular arrhythmias are common after cardiac surgery associated with multiple adverse findings regarding outcome, costs, prolonged hospitalization, complications and reoperation. Therefore, it is an acceptable first-line treatment. Īblation of the arrhythmia is associated with a high long-term success rate and low overall complication rate. Due to the involvement of anatomic structures forming either functional barriers of conduction or even being nonconductive structures, the arrhythmia is usually found to be very stable and not prone to spontaneous termination. Typical atrial flutter is a well-understood arrhythmia resulting from a right atrial macro-reentrant circuit. ![]()
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