221 Complete atrioventricular block during ablation of atrial flutter. Incidence and causes

Abstract

Radiofrequency (RF) ablation of typical atrial flutter (AFl) is largely used to restore and maintain a sinus rhythm. Little is known on the risk of a third degree atrioventricular block (AVB). The purpose of the study was to evaluate the incidence and the causes of iatrogenic complete AVB during RF ablation of a typical AFl. Population AFl ablation was performed in 763 patients (pts), 606 males, 157 females aged from 18 to 90 years (64±12) with recurrent or bad–tolerated typical AFl; 330 pts had associated significant heart disease (valvular 68, congenital 24, ischemic heart disease 71, dilated cardiomyopathy 43, miscellaneous 78) or chronic pulmonary disease (46). Methods AFl RF catheter ablation was performed by conventional method with setting a HALO catheter in coronary sinus and using an 8-F quadripolar with an 8 mm-tip electrode catheter; a maximum power of 70 w and a maximum target temperature of 70 was used. Obtaining a sinus rhythm and a complete isthmus block was the objective of the procedure. Results Complete AVB (1%) was noted when sinus rhythm was restored, in 8 pts aged from 59 to 89 years (73±9) significantly older than other pts (63.5±12) (p Conclusions Complete AVB was a rare complication of RF ablation of typical atrial flutter (1%) which concern old pts; it is significantly more frequent in pts with ischemic heart disease (3/71, 4%) than in pts without ischemic disease (p