Ablation of Right Atrial Flutter in a Sub-Saharan African Country: Experience of Lome (Togo)

Introduction: Atrial flutter is the second most common supraventricular rhythm disorder after atrial fibrillation. Radiofrequency ablation is currently the standard treatment for atrial flutter. Objectives: Firstly, to describe the results of radiofrequency ablation of atrial flutter in LomE, and secondly, to quantify the recurrence rate in patients under follow-up. Methodology: A descriptive study was conducted from April 2023 to April 2024. Patients with typical atrial flutter on surface ECG who underwent electrophysiological exploration were included. An 8 mm/8 Fr non-irrigated catheter and an Ibi Saint Jude radiofrequency generator were used for ablation. A three-month follow-up was performed after ablation. Results: Eleven patients were selected, with a mean age of 49.78 ± 12.21 years. All patients were male. Palpitations were the main symptom (8/11 patients). Hypertension was the predominant aetiology (8/11). The CHA2D2-VA score was ≥ 2 in nine cases. An ECG showed flutter in 10 cases and sinus rhythm in one. Rivaroxaban was the most commonly used anticoagulant. Anti-clockwise flutter was the most frequent type identified during electrophysiological examination. The mean procedure duration was 120 ± 15 minutes, with return to sinus rhythm observed in all cases. Bidirectional block was found in ten cases. One patient presented with a point haemorrhage postoperatively. During follow-up, one case of recurrence was noted at one month, necessitating a second ablation. After three months of follow-up, no recurrence was observed. Conclusion: radiofrequency ablation of isthmo-dependent flutter is a viable treatment option in Togo. The success rate is good, with very few complications. This technique needs to be developed and popularised in other countries.