Pulmonary vein isolation to reduce future risk of atrial fibrillation in patients undergoing typical flutter ablation: Results from a randomized pilot study (REDUCE AF)

Sanghamitra Mohanty, Andrea Natale, Prasant Mohanty, Luigi Di Biase, Chintan Trivedi, Pasquale Santangeli, Rong Bai, J. David Burkhardt, G. Joseph Gallinghouse, Rodney Horton, Javier E. Sanchez, Patrick M. Hranitzky, Amin Al-Ahmad, Steven Hao, Richard Hongo, Salwa Beheiry, Gemma Pelargonio, Giovanni Forleo, Antonio Rossillo, Sakis ThemistoclakisMichela Casella, Antonio Dello Russo, Claudio Tondo, Sanjay Dixit

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Benefits of PVI in Patients with Atrial Flutter Background This study examined incidence of AF following cavotricuspid isthmus (CTI) ablation alone or CTI plus prophylactic pulmonary vein isolation (PVI) in patients presenting with isolated atrial flutter (AFL) with no history of AF. Methods and Results We enrolled 216 patients with isolated typical atrial flutter and randomized them to CTI alone (group 1, n = 108, 61.2 ± 9.7 year, 75% male) or CTI+PVI ablation (group 2, n = 108, 62.4 ± 9.3 year, 73% male). Insertible loop recorder (ILR) was implanted in 21 and 19 patients from groups 1 and 2, respectively. Remaining patients were monitored with event recorders, ECG, 7-day Holter. Follow-up period was for 18 ± 6 months. Compared to group 1, group 2 had significantly longer procedural duration (75.9 ± 33 min vs. 161 ± 48 min [P <0.001]) and fluoroscopy time (15.9 ± 12.3 min vs. 56.4+21 min [P <0.001]). At the end of follow-up, 65 (60.2%) in group 1 and 77 (71.3%) in group 2 were arrhythmia free off-AAD (log-rank P = 0.044). A subgroup analysis was performed with 55 year age cut-off. In the

Original languageEnglish
Pages (from-to)819-825
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume26
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Fingerprint

Atrial Flutter
Pulmonary Veins
Patient Isolation
Atrial Fibrillation
Fluoroscopy
Cardiac Arrhythmias
Electrocardiography
Cohort Studies

Keywords

  • cavotricuspid isthmus ablation
  • new-onset atrial fibrillation
  • outcome
  • prophylactic pulmonary vein isolation
  • typical atrial flutter

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Pulmonary vein isolation to reduce future risk of atrial fibrillation in patients undergoing typical flutter ablation : Results from a randomized pilot study (REDUCE AF). / Mohanty, Sanghamitra; Natale, Andrea; Mohanty, Prasant; Di Biase, Luigi; Trivedi, Chintan; Santangeli, Pasquale; Bai, Rong; Burkhardt, J. David; Gallinghouse, G. Joseph; Horton, Rodney; Sanchez, Javier E.; Hranitzky, Patrick M.; Al-Ahmad, Amin; Hao, Steven; Hongo, Richard; Beheiry, Salwa; Pelargonio, Gemma; Forleo, Giovanni; Rossillo, Antonio; Themistoclakis, Sakis; Casella, Michela; Russo, Antonio Dello; Tondo, Claudio; Dixit, Sanjay.

In: Journal of Cardiovascular Electrophysiology, Vol. 26, No. 8, 01.08.2015, p. 819-825.

Research output: Contribution to journalArticle

Mohanty, S, Natale, A, Mohanty, P, Di Biase, L, Trivedi, C, Santangeli, P, Bai, R, Burkhardt, JD, Gallinghouse, GJ, Horton, R, Sanchez, JE, Hranitzky, PM, Al-Ahmad, A, Hao, S, Hongo, R, Beheiry, S, Pelargonio, G, Forleo, G, Rossillo, A, Themistoclakis, S, Casella, M, Russo, AD, Tondo, C & Dixit, S 2015, 'Pulmonary vein isolation to reduce future risk of atrial fibrillation in patients undergoing typical flutter ablation: Results from a randomized pilot study (REDUCE AF)', Journal of Cardiovascular Electrophysiology, vol. 26, no. 8, pp. 819-825. https://doi.org/10.1111/jce.12688
Mohanty, Sanghamitra ; Natale, Andrea ; Mohanty, Prasant ; Di Biase, Luigi ; Trivedi, Chintan ; Santangeli, Pasquale ; Bai, Rong ; Burkhardt, J. David ; Gallinghouse, G. Joseph ; Horton, Rodney ; Sanchez, Javier E. ; Hranitzky, Patrick M. ; Al-Ahmad, Amin ; Hao, Steven ; Hongo, Richard ; Beheiry, Salwa ; Pelargonio, Gemma ; Forleo, Giovanni ; Rossillo, Antonio ; Themistoclakis, Sakis ; Casella, Michela ; Russo, Antonio Dello ; Tondo, Claudio ; Dixit, Sanjay. / Pulmonary vein isolation to reduce future risk of atrial fibrillation in patients undergoing typical flutter ablation : Results from a randomized pilot study (REDUCE AF). In: Journal of Cardiovascular Electrophysiology. 2015 ; Vol. 26, No. 8. pp. 819-825.
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AU - Natale, Andrea

AU - Mohanty, Prasant

AU - Di Biase, Luigi

AU - Trivedi, Chintan

AU - Santangeli, Pasquale

AU - Bai, Rong

AU - Burkhardt, J. David

AU - Gallinghouse, G. Joseph

AU - Horton, Rodney

AU - Sanchez, Javier E.

AU - Hranitzky, Patrick M.

AU - Al-Ahmad, Amin

AU - Hao, Steven

AU - Hongo, Richard

AU - Beheiry, Salwa

AU - Pelargonio, Gemma

AU - Forleo, Giovanni

AU - Rossillo, Antonio

AU - Themistoclakis, Sakis

AU - Casella, Michela

AU - Russo, Antonio Dello

AU - Tondo, Claudio

AU - Dixit, Sanjay

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N2 - Benefits of PVI in Patients with Atrial Flutter Background This study examined incidence of AF following cavotricuspid isthmus (CTI) ablation alone or CTI plus prophylactic pulmonary vein isolation (PVI) in patients presenting with isolated atrial flutter (AFL) with no history of AF. Methods and Results We enrolled 216 patients with isolated typical atrial flutter and randomized them to CTI alone (group 1, n = 108, 61.2 ± 9.7 year, 75% male) or CTI+PVI ablation (group 2, n = 108, 62.4 ± 9.3 year, 73% male). Insertible loop recorder (ILR) was implanted in 21 and 19 patients from groups 1 and 2, respectively. Remaining patients were monitored with event recorders, ECG, 7-day Holter. Follow-up period was for 18 ± 6 months. Compared to group 1, group 2 had significantly longer procedural duration (75.9 ± 33 min vs. 161 ± 48 min [P <0.001]) and fluoroscopy time (15.9 ± 12.3 min vs. 56.4+21 min [P <0.001]). At the end of follow-up, 65 (60.2%) in group 1 and 77 (71.3%) in group 2 were arrhythmia free off-AAD (log-rank P = 0.044). A subgroup analysis was performed with 55 year age cut-off. In the

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