[Therapeutic value of programmed stimulation in atrial flutter]

Area of Science:

• Cardiology
• Electrophysiology

Context:

• Atrial flutter (a-flut) is a common supraventricular tachyarrhythmia.',
• Therapeutic stimulation is a key intervention for managing cardiac arrhythmias.
• Understanding patient-specific factors influencing treatment outcomes is crucial.

Purpose:

• To evaluate the efficacy and outcomes of programmed stimulation (PS) in terminating atrial flutter (a-flut).
• To analyze the success rates of achieving sinus rhythm (SR) and the incidence of induced atrial fibrillation (a-fib).
• To investigate the influence of patient history, including coronary artery bypass surgery (ACVB) and valve lesions, on PS outcomes.

Summary:

• Programmed stimulation (PS) successfully terminated atrial flutter (a-flut) in a significant portion of 181 cases, achieving sinus rhythm (SR) in 68%.
• Induced atrial fibrillation (a-fib) occurred in 32% of cases. Patients with prior coronary artery bypass surgery (ACVB) showed the highest SR rates (89.5%).
• Outcomes varied based on underlying cardiac conditions, with mitral valve lesions showing higher rates of induced a-fib. Stimulation techniques, except high-rate pacing, were equally effective.

Impact:

• Programmed stimulation is confirmed as an effective therapeutic strategy for both spontaneous and post-operative atrial flutter.
• The study highlights the importance of considering patient-specific cardiac history when predicting PS outcomes.
• Findings provide valuable insights for clinicians managing atrial flutter and optimizing therapeutic stimulation protocols.