Symptomatic improvement after radiofrequency catheter ablation for typicalatrial flutter

Objective-To assess the changes in quality of life, arrhythmia symptoms, an d hospital resource utilisation following catheter ablation of typical atri al flutter. Design-Patient questionnaire to compare the time interval following ablatio n with a similar time interval before ablation. Setting-Tertiary referral centre. Patients-63 consecutive patients were studied. Four patients subsequently u nderwent an ablate and pace procedure, two died of co-morbid illnesses, and two were lost to follow up. The remaining 55 patients form the basis of th e report. Results-Patients were followed for a mean (SD) of 12 (9.5) months. Atrial f lutter ablation resulted in an improvement in quality of life (3.8 v 2.5, p < 0.001) and reductions in symptom frequency score (2.0 v 3.5, p < 0.001) and symptom severity score (2.0 v 3.8, p < 0.001) compared with preablation values. There was a reduction in the number of patients visiting accident and emergency departments (11% v 53%, p < 0.001), requiring cardioversion ( 7% v 51%, p < 0.001), or being admitted to hospital for a rhythm problem (1 1% v 56%, p < 0.001). Subgroup analysis confirmed that patients with atrial flutter and concomitant atrial fibrillation before ablation and those with atrial flutter alone both derived significant benefit from atrial flutter ablation. Patients with concomitant atrial fibrillation had an improvement in quality of life (3.5 v 2.5, p < 0.001) and reductions in symptom frequen cy score (2.3 v 3.5, p < 0.001) and symptom severity score (2.2 v 3.7, p < 0.001) compared with preablation values. Conclusions-Ablation of atrial flutter is recommended both in patients with atrial flutter alone and in those with concomitant atrial fibrillation.