Right Atrial Remodeling in Atril Fibrillation: Is It Particular to an Incidence of Typical Right Atrial Flutter?

概要

論文の詳細を見る
Backgrounds: Typical right atrial flutter (RAFL) is the most frequent tachycardia coexistent with atrial fibrillation (AF), and treated by catheter ablation (CA) of the cavotricuspid isthmus as combined therapy with pulmonary vein isolation. However, the clinical features and pathophysiology of coexistence of RAFL with AF are unclear. Methods: We studied 119 consecutive patients (61±11 years, 88 males) who underwent CA for AF and divided into 2 groups according to existence of RAFL, which was documented clinically or induced by atrial stimulation during ablation sessions. Group 1 included 35 patients with RAFL, and group 2 consisted of the remaining 84 patients without RAFL. Results: Persistent AF was found in 18/35 patients (51.4%) in group 1, while in 20/84 patients (23.8%) in group 2 (p<0.05). Higher BNP (p<0.05), lower left ventricular ejection fraction (LVEF) (p<0.05) and longer long-axis length of the right atrium (RA) (55.8±7.5 vs 51.5±6.5 mm; p<0.01), were observed in group 1 than in group 2. Conversely, there were no significant differences in any parameters of the left atrium (LA) between the groups. Conclusion: Incidence of RAFL was related to persistency of AF. RA remodeling, involved in a different mechanism from the LA, might promote RAFL with AF.