Atrial Flutter Induced by Class IC Drugs/Amiodarone: What Are the Long-term Results of Cavo-tricuspidal Isthmus Ablation?
Many patients present with both atrial fibrillation (AFib) and atrial flutter (AFL) [1–8]. For example, 5–22% of patients with AFib also have AFL [4–8] and at least 10–35% 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 supraventricular 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  as “tachycardia-induced tachycardia.” Finally, the two arrhythmias may have a common trigger constituted by automatic foci of pulmonary veins .
KeywordsAtrial Fibrillation Antiarrhythmic Drug Atrial Flutter Pulmonary Vein Isolation Radiofrequency Catheter Ablation
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