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Atrial flutter and thromboembolic risk: a systematic review
Henrik Vadmann1, Peter Brønnum Nielsen1, Søren Pihlkjær Hjortshøj2
1Department of Cardiology, Atrial Fibrillation Study group, Aalborg University Hospital, Aalborg, Denmark Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Heart (British Cardiac Society)
|July 8, 2015
Summary
Atrial flutter is linked to a higher risk of thromboembolic events, including stroke and mortality. This systematic review confirms a high prevalence of left atrial thrombus and spontaneous echo contrast in patients with atrial flutter.
Area of Science:
- Cardiology
- Thrombosis Research
- Systematic Reviews
Background:
- Atrial flutter poses a thromboembolic risk, yet it is less studied than atrial fibrillation.
- Existing research on atrial flutter and thromboembolism is limited.
Purpose of the Study:
- To conduct an up-to-date systematic review of the literature.
- To investigate the association between atrial flutter and thromboembolic events.
Main Methods:
- Systematic literature search using MEDLINE and EMBASE.
- Manual search of reference lists.
- Inclusion of international guidelines, meta-analyses, reviews, case reports, studies on ablation/cardioversion, echocardiography, and observational studies.
- A total of 52 articles were included.
Main Results:
- Thromboembolic event rates during cardioversion ranged from 0% to 6%.
- Echocardiographic studies showed thrombus prevalence of 0%–38% and spontaneous echo contrast (SEC) of 21%–28%.
- Observational studies indicated elevated stroke risk (RR 1.4) and mortality risk (HR 1.9) in atrial flutter patients.
Conclusions:
- This systematic review confirms a high prevalence of clinical thromboembolic events, left atrial thrombus, and SEC in atrial flutter.
- Despite data limitations and heterogeneity, the findings underscore the thromboembolic risk associated with atrial flutter.
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