209: Incidence of atrial fibrillation in patients with atrial flutter before and after ablation according to the nature of associated heart disease

Radiofrequency (RF) ablation is a treatment of choice of typical atrial flutter (AFl). However the risk of atrial fibrillation (AF) is high. Heart disease (HD) presence may modify this risk. The purpose of the study was to look for the role of associated HD on previous history of AF and later occurrence of AF after AFl ablation. Methods 965 patients, mean age 64±12, were consecutively referred for ablation of recurrent or poor-tolerated AFL. Clinical history, occurrence of AF, data of echocardiography was collected. Patients were followed from 3 months up to 10 years. Antiarrhythmic drugs were stopped after ablation except in patients with history of AF before ablation. Results HD was present in 744 patients (77%): hypertensive disease (HTD) (n=186), ischemic HD (IHD) (n=163), valvular HD (VHD) (n=113), dilated cardiomyopathy (DCM) (n= 87), respiratory failure (resp) (n=84), congenital HD (cong) (n=26), miscellaneous HD (n=59). Prior AF was more frequent in patients without HD (67%) than in patients with HD (26%)(p Conclusions Surprisingly patients without HD had more frequently prior AF than patients with HD. However after AFl ablation AF risk was similar. Antiarrhythmic drugs maintained in patients with AF history could have decreased the risk of subsequent AF. Prior AF was more frequent in patients with DCM than in patients with other HD. After AFl ablation only patients with congenital HD seem to have a high risk of developing AF compared to patients with HD of other origin or patients without HD.