Complications of atrial flutter ablation1/21/2024 Any of the following endpoints counted as a MAE: death, stroke/transient ischaemic attack, myocardial infarction, pericarditis requiring pericardiocentesis or prolongation of hospital stay or readmission, cardiac perforation/tamponade, bleeding at vascular access site requiring intervention, pneumothorax requiring intervention (after removal of chest drain, symptomatic pulmonary vein stenosis > 70%, permanent phrenic nerve paralysis, atrio-oesophageal fistula, major vascular complications and infection at surgical or puncture site requiring surgical intervention. Primary safety endpoint was a composite of major adverse events (MAE) and complications occurring within 30 days post procedure. This feasibility study would assess recruitment to the trial, safety and efficacy of the Convergent procedure, in combination with a left atrial appendage system. Patients with long-standing persistent AF will be randomised in a 1:1 ratio to either the Convergent ablation with the LARIAT procedure or the standard endocardial catheter ablation. The second stage involves endocardial catheter ablation to confirm the surgical ablation lesions, and perform further endocardial catheter ablation to leverage both epicardial and endocardial lesions to create durable, transmural lesions. The first stage employs surgical ablation to the posterior wall of the left atrium in combination with the LARIAT procedure to isolate the left atrium appendage (LAA). The Convergent procedure - is a two stage minimally invasive hybrid approach. If this was improved, patient quality of life and readmission rates would significantly improve as well as a reduction in anti-arrhythmic drug use. Currently success rates for catheter ablation are moderate at 40 to 70% in a single procedure. Treatment options are limited for persistent long-standing AF (PeAF), with pulmonary vein isolation by endocardial ablation being insufficient and further additive endocardial lesions with repeated ablations yield mixed results resultant in further atrial arrhythmias. Even after a successful ablation, 25 to 80 of people get atrial fibrillation. Ablation may cause complications, such as a stroke. Why Should I Register and Submit Results?Ītrial Fibrillation is the commonest arrhythmia and is a major cause of morbidity and mortality, often causative in ischaemic strokes and compounded by heart failure. People with complex cases of atypical atrial flutter may have only a 70 success rate with ablation.In this procedure, a surgeon will thread a catheter to your heart and use radio wave energy to create scar tissue that blocks the abnormal electrical pathways involved in atrial flutter. Blood thinners (anticoagulants) or aspirin can help reduce your risk of blood clots.Ī procedure called electrical cardioversion - in which you’re given a brief, low-power electrical shock through your chest while under anesthesia - is often used to restore a normal sinus heart rhythm.Īlthough this treatment is effective, people often experience a return of arrhythmia at some point in the future.Īntiarrhythmic medication, such as sodium-channel or potassium-channel blockers, may help restore a normal rhythm or maintain normal rhythm after electrical cardioversion.Īlternatively, your doctor may advise radio frequency ablation to convert an atrial flutter to normal sinus rhythm. Several classes of medication can help slow your heart rate, including beta blockers, calcium channel blockers, and digoxin. Treatment of atrial flutter focuses on slowing the heart rate, reducing the risk of stroke, and converting the flutter to a normal rhythm driven by the sinus node. If an EKG shows that you have atrial flutter (shown by the “sawtooth” pattern), your doctor may also conduct an ultrasound of your heart (echocardiogram) to evaluate your heart and spot any blood clots. These clots can travel to the brain and block an artery, causing a stroke or a cold arm or leg if, for example, the clots travel to a major artery in your limbs.Īlso, in people with atrial flutter, the ventricles don’t completely fill with blood and may not pump enough blood to meet the body’s needs, resulting in heart failure.Ītrial flutter is diagnosed based on your medical and family history, a physical exam, and an EKG, according to the Merck Manual. Blood moves more slowly through the heart and may stagnate, allowing small blood clots to form. Some people don’t experience any symptoms from atrial flutter.Īlthough the heart beats more rapidly in people with atrial flutter, it doesn’t fully contract, and the atria don’t empty completely into the ventricles. Lightheadedness, dizziness, or fainting.Palpitations (racing, pounding, or fluttering of the heart).Atrial Flutter Symptoms and ComplicationsĪside from a rapid heart rate, symptoms of atrial flutter include the following, according to the Heart Rhythm Society and MedlinePlus:
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