What is the prevalence of pediatric atrial flutter?

Updated: Feb 04, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Answer

Atrial flutter is most commonly seen after the Senning or Mustard surgical procedures for transposition of the great arteries (used in the past) and after Fontan repair. According to a United States study, 57% of patients with double-inlet left ventricle who undergo the Fontan operation may be expected to present with atrial flutter or fibrillation by 20 years after surgery. [9] This high prevalence of atrial flutter or fibrillation seen in the atriopulmonary connection type of Fontan operation, however, is not as frequent with the total cavopulmonary connection type of Fontan procedure. The mean annual incidence of new dysrhythmias (predominantly atrial flutter) after the Fontan operation is 5%. According to a multicenter study, tachyarrhythmia prevalence over time was similar between the intracardiac lateral tunnel and the extracardiac conduit Fontan operations. [10]

In an international review, atrial flutter accounted for 26.2% of all cases of fetal tachyarrhythmias, and supraventricular tachycardia (SVT) accounted for 73.2%. [11] In an earlier population study of 3383 English newborns by Southall and colleagues, only 1 newborn had atrial flutter. [12] This likely underestimated the incidence of atrial flutter in utero because spontaneous conversion often occurs during birth and subsequent recurrence is uncommon.

A long-term follow-up study into adulthood of patients undergoing the Mustard or Senning procedure for correction of D-transposition of the great arteries demonstrated SVT in 48%, of which atrial flutter was the most common type (73%). Arrhythmias accounted for 12.7% of pediatric cardiology consultations in a major pediatric academic medical center, of which atrial flutter was the second most common type.


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