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J Am Coll Cardiol. 1997 Nov 15;30(6):1506-11.

Thromboembolism in chronic atrial flutter: is the risk underestimated?

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1
Division of Cardiology, Loyola University Medical Center, Maywood, Illinois 60153, USA.

Abstract

OBJECTIVES:

We sought to evaluate the risk of thromboembolic events in the presence of chronic atrial flutter and to determine the impact of anticoagulation therapy, if any, on this risk.

BACKGROUND:

Thromboembolic events are thought to be rare after cardioversion of atrial flutter.

METHODS:

This study was a retrospective analysis of 110 consecutive patients referred to the electrophysiology laboratory for cardioversion of chronic atrial flutter from 1986 to 1996. Atrial flutter was present for at least 6 months. Of the 110 patients reviewed, 100 had adequate information available regarding the effectiveness of anticoagulation (mean age 64 years, range 27 to 86; 75 men, 25 women; mean left ventricular ejection fraction 42%).

RESULTS:

Thirteen patients (13%) had a thromboembolic event. Of these, seven were attributable to causes other than atrial flutter. In the remaining six patients (6%), thromboembolic events occurred during a rhythm of atrial flutter or after cardioversion to sinus rhythm. Other causes of thromboembolism were excluded. Effective anticoagulation was associated with a decreased risk of thromboembolism (p = 0.026).

CONCLUSIONS:

Patients with chronic atrial flutter are at an increased risk of thromboembolic events. Effective anticoagulation may decrease this risk.

PMID:
9362409
DOI:
10.1016/s0735-1097(97)00326-4
[Indexed for MEDLINE]
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