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Published on: February 26, 2013
Incidence of Atrial Fibrillation in African Americans post Atrial Flutter Ablation
Robert L Percell1, Robert Helm2, Kevin Monahan2
1Electrophysiology Department, Bryan Heart Institute, 1600 S 48th Street, Lincoln, NE 68506, Lincoln, NE 68506.
Insights
African Americans experienced a lower incidence of atrial fibrillation (AF) after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL). This study highlights racial differences in post-ablation outcomes.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- African Americans exhibit lower rates of atrial arrhythmias, including atrial fibrillation (AF) and atrial flutter (AFL), despite higher cardiovascular risk.
- Atrial fibrillation incidence post-cavotricuspid isthmus (CTI) ablation for typical AFL approaches 40% in some studies.
- The specific incidence of AF post-CTI ablation in African Americans with typical AFL remains understudied.
Purpose of the Study:
- To investigate racial disparities in the development of AF after CTI ablation for typical AFL.
- To compare AF incidence between African American and non-African American patients undergoing CTI ablation for typical AFL.
Main Methods:
- Retrospective review of electronic medical records for patients undergoing first-time, successful CTI ablation for typical AFL over 48 months.
- Data collection included clinical variables, AF diagnosis via ECG, Holter, event monitor, or device interrogation.
- Follow-up was conducted over a 1-year period, with patients self-identifying race/ethnicity.
Main Results:
- A total of 201 patients (51 African Americans, 150 non-African Americans) were analyzed; average age and sex distribution were similar.
- African Americans showed a significantly lower incidence of AF post-CTI ablation compared to non-African Americans (22.2% vs. 46.6%, p=0.002).
- Women were more likely to develop AF (53.1%), and African American men had the lowest incidence post-ablation (p=0.0062).
Conclusions:
- A significantly lower incidence of AF was observed in African American patients following CTI ablation for typical AFL.
- Racial differences exist in the development of AF after CTI ablation for typical AFL.
Background:
African Americans have a lower incidence of atrial arrhythmias both atrial fibrillation (AF) and atrial flutter (AFL) despite having a greater number of traditional risk factors. The incidence of atrial fibrillation after cavotricuspid isthmus (CTI) ablation in patients with typical AFL is markedly increased approaching 40% in some studies. It is unknown if African Americans specifically have a similar rate of increased AF after CTI ablation for typical AFL.We sought to identify differences in development of AF after CTI ablation for typical AFL with regards to race, between African American and non- African Americans. The hypothesis is that African Americans will have a lower incidence of AF after CTI ablation for typical AFL.
Methods:
The electronic medical records of first time, successful CTI ablations performed for typical (AFL) were retrospectively reviewed over a 48 month period. Clinical variables were retrieved from the EMR. AFL was documented on ECG, Holter/ event monitor or device interrogation at clinical follow up visits. Follow up was obtained over a 1 year period. Patients were self-identified as African American, White, Hispanic or Other.
Results:
The records of a total of 201 patients - 51 African Americans (25.4%) and 150 non-African Americans (74.6%) - who underwent CTI ablation for typical AFL were examined. Average age was similar (67.8 vs 66.3, p=NS) with a preponderance of men (77.6% vs 23.5%). There was a significantly lower rate of development of AF post CTI ablation for typical AFL in African Americans vs non-African Americans (22.2% vs 46.6%, p=0.002). Additionally, women were more likely to develop AF (53.1% vs 36.2%, p=0.026). African American men were the least likely to develop AF post AFL ablation (p=0.0062).
Conclusions:
We observed a significantly lower incidence of AF among African American patients after CTI ablation for typical AFL.
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