Atrial flutter, time to acknowledge its own identity (original) (raw)
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Canadian Journal of Cardiology, 2018
We examine the incidence of atrial fibrillation and stroke in a large real-world cohort of patients with atrial flutter, and the impact of atrial flutter ablation. Patients with atrial flutter developed atrial fibrillation and stroke at a higher rate than the general population. Atrial flutter ablation reduces but does not eliminate the incidence of atrial fibrillation. Continued anticoagulation after successful flutter ablation may be indicated, as ablation does not entirely eliminate future AF incidence.
Ten years differences in recently onset atrial fibrillation and flutter incidence and management
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2014
Ten years differences in recently onset atrial OBJECTS AND BACKGROUND: Atrial fibrillation (AF) and atrial flutter (AFl) are the most common arrhythmias in day-life clinical practice. Purpose of our study was to verify differences occurred in the last ten years in AF and AFI incidence and treatment in the emergency room (ER). from the 17th January to the 15th February 2000 and from the 18th January to the 16th February 2010 all the consecutive patients with AF or AFl referring to the ER of our hospital were included in the study. Epidemiological data were collected along with information about treatment, admission to hospital wards, days of hospital stay and therapy. Data from the year 2000 were compared to these collected ten years later. incidence of AF and AFl has increased in the years (50%), patients are older (73.5 vs. 65.2 years; p 0.029) and refer late to the ER (45.6% in 2010 and 23.7% in 2000 with a delay of > 48 hours from arrhythmias onset; p 0.054). In 2010 only a mi...
The American Journal of Cardiology, 2014
Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 -1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n [ 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p [ 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p [ 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p [ 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not. Ó 2014 Elsevier Inc. All rights reserved. (Am J Cardiol 2014;114:1361e1367)
Prognostic differences between atrial fibrillation and atrial flutter
The American Journal of Cardiology, 2004
This report presents the outcome of a cohort of 94 patients with atrial fibrillation from the Canadian Registry of Atrial Fibrillation, in which we paid particular attention to the probability of stroke and death. We also evaluated warfarin use over time and compared left atrial dimensions in patients with atrial flutter with those with atrial fibrilliation. ᮊ2004 by
Atrial Flutter - Clinical Risk Factors and Adverse Outcomes in the Framingham Heart Study
Heart rhythm : the official journal of the Heart Rhythm Society, 2015
Few epidemiological cohort studies have evaluated atrial flutter (flutter) as an arrhythmia distinct from atrial fibrillation (AF). To examine the clinical correlates of flutter and its associated outcomes to distinguish them from those associated with AF in the Framingham Heart Study. We reviewed and adjudicated electrocardiograms previously classified as flutter or AF/flutter and another 100 electrocardiograms randomly selected from AF cases. We examined the clinical correlates of flutter by matching up to 5 AF and 5 referents to each flutter case using a nested case-referent design. We determined the 10-year outcomes associated with flutter with Cox models. During mean follow-up of 33.0±12.2 years, 112 participants (mean age 72±10 years, 30% women) developed flutter. In multivariable analyses, smoking (odds ratio [OR] 2.84; 95% confidence interval [CI], 1.54 to 5.23), increased PR interval (OR 1.28 per SD; 95% CI, 1.03 to 1.60), myocardial infarction (OR 2.25; 95% CI, 1.05 to 4.8...
1:1 atrial-flutter. Prevalence and clinical characteristics
International Journal of Cardiology, 2013
Little is known about the epidemiology of 1:1 atrial flutter (AFL). Our objectives were to determine its prevalence and predisposing conditions. Methods: 1037 patients aged 16 to 93 years (mean 64 ± 12) were consecutively referred for AFL ablation. 791 had heart disease (HD). Patients admitted with 1/1 AFL were collected. Patients were followed 3 ± 3 years. Results: 1:1 AFL-related tachycardiomyopathy was found in 85 patients, 59 men (69%) with a mean age of 59 ± 12 years. The prevalence was 8%. They were compared to 952 patients, 741 men (78%, 0.04), with a mean age of 65 ± 12 years (0.002) without 1:1 AFL. Factors favoring 1:1 AFL was the absence of HD (35 vs 23%, 0.006), the history of AF (42 vs 30.5%)(0.025) and the use of class I antiarrhythmic drugs (34 vs 13%)(p b 0.0001), while use of amiodarone or beta blockers was less frequent in patients with 1:1 AFL (5, 3.5%) than in patients without 1:1 AFL (25, 15%) (p b 0.0001, 0.03). The failure of ablation (9.4 vs 11%), ablation-related complications (2.3 vs 1.4%), risk of subsequent atrial fibrillation (AF) (20 vs 24%), risk of AFL recurrences (19 vs 13%) and risk of cardiac death (5 vs 6%) were similar in patients with and without 1:1 AFL. Conclusions: The prevalence of 1:1 AFL in patients admitted for AFL ablation was 8%. These patients were younger, had less frequent HD, had more frequent history of AF and received more frequently class I antiarrhythmic drugs than patients without 1:1 AFL. Their prognosis was similar to patients without 1:1 AFL.
Fatores preditores de fibrilação atrial após ablação do flutter atrial típico
Arquivos Brasileiros de Cardiologia, 2009
Background: The occurrence of atrial fibrillation (AF) after successful ablation of cavotricuspid isthmus-dependent atrial flutter (CTI-AFL) is an important medical event, but predictors of this event are still controversial. Objective: To determine the incidence of AF and its predictors in patients undergoing ablation of cavotricuspid isthmusdependent atrial flutter (CTI-AFL).