Abstract 12570: Catheter Ablation Rates for Typical Atrial Flutter in Military Tactical Athletes

Abstract

Introduction: Cavotricuspid isthmus (CTI)-dependent atrial flutter is known to adversely impact exercise physiology and occupational readiness in active-duty military personnel. Despite guideline recommendations supporting catheter ablation for CTI-dependent flutter, there is a paucity of literature reporting the utilization and outcomes of catheter ablation in military personnel and other tactical athletes. Aims: This study aims to characterize United States military personnel diagnosed with CTI-dependent flutter and investigate the rates of catheter ablation and personnel returning to tactical athletic occupations. Methods: Military personnel diagnosed with CTI-dependent flutter from 2016 to 2022 were analyzed. Baseline clinical characteristics and typical flutter management was reviewed. CTI-flutter diagnoses were confirmed by electrocardiogram and electrophysiology study with entrainment or activation mapping. Results: During the study dates 40 military members (mean age, 40.7±10.7 years; 98% male; mean BMI 28.3±4.2 kg/m 2 ; mean LVEF 58.3%±7.7) were diagnosed with typical flutter. 34/40 (85%) of service members diagnosed with typical flutter were retained on military status after diagnosis. Of those retained, 13/34 (38.2%) were able to complete deployments. Electrophysiology study and successful CTI ablation was performed in 27/40 (67.5%) of personnel with zero complications. 26/27 (96.3%) servicemembers who underwent CTI ablation maintained their tactical occupation whereas only 8/13 (61.2%) service members who did not receive CTI ablation were retained (p=0.009). 10/27 (37.0%) who received CTI ablation were able to subsequently deploy whereas only 3/13 (23%) who did not receive CTI ablation were able to deploy (p=0.484). Conclusions: Most military tactical athletes with CTI-dependent flutter receive safe and effective CTI ablations. CTI ablation increases tactical occupation retention rates when compared to treatment without CTI ablation. This data supports the use of CTI ablation as first-line treatment for military personnel and highlights the role of increasing ablation rates in other similar athletic populations.