What is the prevalence of thrombotic events in atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Other reports have demonstrated thrombus in the left atrial appendage of patients with atrial flutter (as many as 43%). Most studies of nonanticoagulated patients with atrial flutter report a rate of 10-15% for patients with thrombus in the left atrium or left atrial appendage. Spontaneous echo contrast that was associated with an increased risk of thromboembolism was found in 6-43% of patients with atrial flutter.

Patients with atrial flutter and episodes of atrial fibrillation are at higher risk for thromboembolic events; however, determining whether episodes of atrial fibrillation are associated with episodes of atrial flutter is difficult.

A large retrospective review of patients in chronic atrial flutter revealed a 14% occurrence rate of thromboembolic events over 4.5 years, with half of these events being ischemic stroke. In another large cohort of patients with atrial flutter, the occurrence rate of embolic complications in patients with chronic or recurrent atrial flutter was 12%.

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