What is the thromboembolic risk associated with atrial flutter?
A systematic review on the thromboembolic risk associated with atrial flutter, including 52 articles, found that thromboembolic event rates after cardioversion varied from 0% to 6% with a follow-up from 1 week to 6 months. Echocardiographic studies reported prevalence of intra-atrial thrombi from 0% to 38% and a prevalence of spontaneous echo contrast up to 48%. One ablation study in non-anticoagulated patients with atrial flutter reported thromboembolic events in 13.9% of cases. Observational studies demonstrated an increased risk of stroke (RR, 2.23; 95% CI, 1.37–3.62) compared with control subjects at long-term follow-up.