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The natural history of lone atrial flutter

Sean C Halligan1, Bernard J Gersh, Robert D Brown

  • 1Mayo Clinic, Rochester, Minnesota 55905, USA.

Annals of Internal Medicine
|February 19, 2004
PubMed

Insights

Lone atrial flutter presents a stroke risk comparable to lone atrial fibrillation. Patients with atrial flutter have a significantly higher likelihood of developing atrial fibrillation, necessitating consideration of anticoagulation, especially for those over 65.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Clinical Medicine

Background:

  • The natural history and associated risks of atrial flutter remain incompletely understood.
  • Atrial flutter is a common supraventricular tachyarrhythmia with potential for significant morbidity.

Purpose of the Study:

  • To investigate the risk of stroke in patients with lone atrial flutter.
  • To determine the rate of conversion from atrial flutter to atrial fibrillation.
  • To evaluate the need for anticoagulation in atrial flutter management.

Main Methods:

  • Retrospective cohort analysis of 59 inpatients and outpatients diagnosed with atrial flutter.
  • Comparison of stroke rates in atrial flutter patients against control groups, including those with lone atrial fibrillation.
  • Longitudinal data collection on electrocardiograms and clinical information.

Main Results:

  • Patients with atrial flutter exhibited a higher incidence of thromboembolic events compared to control groups, even after adjusting for age and sex.
  • Atrial fibrillation developed in 56% of patients initially presenting with atrial flutter.
  • The stroke risk in lone atrial flutter was found to be at least as high as in lone atrial fibrillation.

Conclusions:

  • Lone atrial flutter carries a substantial stroke risk, comparable to lone atrial fibrillation.
  • There is a significantly elevated risk of developing atrial fibrillation in patients with atrial flutter.
  • Anticoagulation therapy should be strongly considered for all atrial flutter patients aged over 65.
Abstract

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