Catheter Ablation for Typical Atrial Flutter in Tactical Athletes

Despite guideline recommendations supporting catheter ablation for typical atrial flutter (AFL), there is a paucity of literature reporting the utilization and outcomes of ablation in tactical athletes. This study aims to characterize military personnel diagnosed with typical AFL and investigate the rates of catheter ablation and personnel returning to normal activities.

Military personnel diagnosed with typical AFL from 2016 to 2022 were analyzed and the management was reviewed. Typical AFL diagnoses were confirmed by electrocardiogram and electrophysiology study with entrainment or activation mapping.

Forty personnel (mean age, 40.7±10.7 years; 98% male; mean BMI 28.3±4.2 kg/m2; mean left ventricular ejection fraction [LVEF] 58.3%±7.7) were diagnosed with typical AFL. 34/40 (85%) of service members diagnosed with typical AFL were retained on military status after diagnosis. Electrophysiology study and successful ablation was performed in 27/40 (67.5%) of personnel with no complications. 26/27 (96.3%) service members who underwent ablation were retained, whereas only 8/13 (61.2%) service members who did not receive ablation were retained (P = .001, Figure 1).

Military tactical athletes with typical AFL receive safe and effective ablations. Ablation is associated with increases in military retention rates and return to normal activity when compared to treatment without ablation. These data support the use of ablation as first-line treatment for athletic populations with typical AFL. Future studies with a larger sample size should be performed to confirm these findings.