[Specific percutaneous radiofrequency ablation of atrial flutter]

Radiofrequency catheter ablation has recently been successfully applied to patients suffering from atrial flutter. We report our experience in the ablation of typical atrial flutter in 17 consecutive patients refractory to drug treatment. The procedure was initially successful restoring sinus rhythm in 16 patients (94%). During a mean follow-up of 9 months atrial flutter recurred in 4 patients (23%). A second procedure was successfully performed in 2 patients; the other two patients are presently in sinus rhythm under amiodarone which was formerly ineffective. Finally, 59% of the patients were able to discontinue antiarrhythmic medication. In 4 out of 7 patients with dilated cardiomyopathy, the left ventricular ejection fraction normalized a few weeks after ablation. This successful technique should be considered early in the therapeutic approach to patients suffering from typical atrial flutter, to avoid numerous drug treatments, multiple hospitalizations and possible evolution toward non reversible dilated cardiomyopathy.