What is the risk of thromboembolism and stroke in patients with atrial flutter?
The risk of thromboembolism and stroke in patients with atrial flutter has been evaluated in relatively few studies compared with AF. 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 56%. 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, 1.36-2.15) compared with control subjects at long-term follow-up.