OBJECTIVE

To analyze the long-term outcomes of preventive ablation of the cavotricuspid isthmus (CTI) in patients with risk factors of typical atrial flutter (AFL).

MATERIAL AND METHODS

The study was performed in 2018—2019. Inclusion criteria: paroxysmal atrial fibrillation (AF), no confirmed AFL, risk factors of AFL (chronic heart failure, chronic obstructive pulmonary disease, prolonged p-r interval, smoking, previous myocardial infarction). Exclusion criteria: previous typical or atypical atrial flutter. The study included 42 patients. In the first group (n=21), pulmonary vein isolation alone (PVI) was performed, in the second group — PVI with CTI ablation.

RESULTS

Efficiency of PVI and CTI ablation was 100%. AF paroxysms occurred in 4 (19.1%) patients in the first group and 5 (23.8%) patients in the second group throughout the blind period (3 months). Efficiency of surgery regarding recurrent AF within one year was 76.2% in the first group and 71.4% in the second group. No recurrent AFL was observed in the second group. In the first group, there were 3 (14.3%) cases of AFL. There were no significant differences in the incidence and structure of intraoperative complications. Mean surgery time was 87±13 min in the first group, 95±14 min in the second group.

CONCLUSION

Preventive CTI ablation slightly increases surgery time and does not affect the number of complications. Preventive CTI ablation is advisable in patients with risk factors of AFL.