Risk of new-onset atrial fibrillation and stroke after radiofrequency ablation of isolated, typical atrial flutter

Jessica Voight, Mehmet Akkaya, Porur Somasundaram, Rehan Karim, Salimah Valliani, Younghoon Kwon, Selcuk Adabag

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Background Radiofrequency ablation (RFA) is considered a curative procedure for typical atrial flutter (AFL); however, patients remain at risk for developing new atrial fibrillation (AF). Objective The purpose of this study was to determine the incidence and predictors of new-onset AF and stroke after RFA of isolated AFL in a multicenter cohort. Methods The study included 315 consecutive patients who underwent successful RFA of isolated, typical AFL from 2006 to 2013 at 4 community and teaching hospitals. Patients with any history of AF prior to RFA were excluded. Results During 2.5 ± 1.8 years of follow-up after RFA, 80 patients (25%) developed new AF. In multivariate analysis, after adjusting for baseline medical therapy, obstructive sleep apnea and left atrial enlargement were independently associated with the development of new AF. Presence of a cardiac implantable electronic device (CIED) was associated with a 3.6-fold (95% confidence interval 1.9–6.6, P <.0001) increase in the likelihood of AF detection. New AF was detected in 48% of patients with CIED and 35% of those who underwent Holter ECG vs 19% of those with clinical follow-up only (P <.0001). Anticoagulation was stopped in 58% patients an average of 3.3 ± 4.8 months after RFA. Stroke occurred in 3 patients (1%) during the follow-up period. Conclusion New AF occurs in ≥25% of patients after RFA of isolated typical AFL, but stroke is relatively rare. Obstructive sleep apnea and left atrial enlargement are risk factors for AF. The presence of a CIED significantly enhances the likelihood of detecting new AF, demonstrating the importance of arrhythmia surveillance after RFA of AFL.

Original languageEnglish (US)
Pages (from-to)1884-1889
Number of pages6
JournalHeart Rhythm
Issue number11
StatePublished - Nov 2014


  • Atrial fibrillation
  • Atrial flutter
  • Cardiac implantable electronic device
  • Obstructive sleep apnea
  • Radiofrequency ablation


Dive into the research topics of 'Risk of new-onset atrial fibrillation and stroke after radiofrequency ablation of isolated, typical atrial flutter'. Together they form a unique fingerprint.

Cite this