Atrial Flutter Induced by Class IC Drugs/Amiodarone: What Are the Long-term Results of Cavo-tricuspidal Isthmus Ablation?

摘要

Many patients present with both atrial fibrillation (AFib) and atrial flutter (AFL) [1-8]. For example, 5-22(percent) of patients with AFib also have AFL [4-8] and at least 10-35(percent) of patients with clinically predominant AFL also suffer from AFib [1-4]. Association of the two arrhythmias in the same patient is related to multiple factors. First, the same atrial anatomic substrate can facilitate both multiple wavelet re-entry of AFib and right-atrial macro-re-entry of AFL. Second, AFib can trigger AFL [1, 2]. Third, AFL, like other supraventricu-lar arrhythmias (focal atrial tachycardia, atrioventricular re-entrant tachycardia related to an overt or a concealed Kent bundle, and atrioventricular nodal re-entrant tachycardia) [9-12] can trigger AFib, a phenomenon that has been described by Pristowsky [13] as "tachycardia-induced tachycardia." Finally, the two arrhythmias may have a common trigger constituted by automatic foci of pulmonary veins [12].