Abstract

Introduction: Patients undergoing typical atrial flutter (AFL) ablation remain at risk of developing atrial fibrillation (AF). However, it is unknown whether common risk factors associated with AF occurrence, particularly race, bear out in this population. Hypothesis: We sought to compare the occurrence of new AF in male veteran African-American (AA) and Caucasian (Cau) patients with AFL following successful cavo-tricuspid isthmus ablation. Methods: A retrospective review of patients undergoing AFL ablation between 2002 and 2019 was performed. Patients with prior history of AF were excluded. Records were reviewed and demographics, comorbidities and post-ablation outcomes including new AF and stroke were recorded. The overall incidence of AF and cases per 1000 person-years (CPTPY) were determined. Results: The study cohort comprised 217 patients (age: 66±9.3 years, AA: 97 [45%], Cau:108 [50%]; see Table) with a mean follow-up of 55±42 months after AFL ablation. New AF was detected in 30 (31%) AA and 45 (42%) Cau patients (p=0.21 by Log Rank test). Overall incidence of AF was 78 CPTPY (67 and 91 CPTPY cases in AA and Cau patients, respectively). Time to occurrence of AF was earlier in Cau than AA patients (p=<0.001). New stroke events occurred in 9 (4.4%) patients (4 AA, 5 Cau; p=0.86). Conclusions: Male AA and Cau patients have similar significant risks for developing AF and experiencing stroke after AFL ablation.

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