Preventive block of the cavotricuspid isthmus in interventional treatment of atrial fibrillation

Objective. To analyze the long-term outcomes of preventive ablation of the cavotricuspid isthmus (CTI) in patients with risk factors of typical atrial flutter (AFL). Material and methods. The study was performed in 2018—2019. Inclusion criteria: paroxysmal atrial fibrillation (AF), no con-firmed AFL, risk factors of AFL (chronic heart failure, chronic obstructive pulmonary disease, prolonged p-r interval, smoking, previous myocardial infarction). Exclusion criteria: previous typical or atypical atrial flutter. The study included 42 patients. In the first group (n=21), pulmonary vein isolation alone (PVI) was performed, in the second group — PVI with CTI ablation. Results. Efficiency of PVI and CTI ablation was 100%. AF paroxysms occurred in 4 (19.1%) patients in the first group and 5 (23.8%) patients in the second group throughout the blind period (3 months). Efficiency of surgery regarding recurrent AF within one year was 76.2% in the first group and 71.4% in the second group. No recurrent AFL was observed in the second group. In the first group, there were 3 (14.3%) cases of AFL. There were no significant differences in the incidence and structure of intraoperative compli-cations. Mean surgery time was 87±13 min in the first group, 95±14 min in the second group. Conclusion. Preventive CTI ablation slightly increases surgery time and does not affect the number of complications. Preventive CTI ablation is advisable in patients with risk factors of AFL. © 2021, Media Sphera Publishing Group. All rights reserved.