Cited by 135Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsVenous Thromboembolism Diagnosis and Management

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Risk of thromboembolic events in patients with atrial flutter

Seidl, Karlheinz, Hauer, Bernd, Schwick, Nicola G, Zellner, Dietmar, Zahn, Ralf, Senges, Jochen·1998·The American Journal of Cardiology

DOI 10.1016/s0002-9149(98)00419-6

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Abstract

Based on multiple studies, clear, guided anticoagulation therapy is recommended for patients with atrial fibrillation. The value of anticoagulation therapy in patients with atrial flutter, however, is less well established. Little is known about the incidence of thromboembolism in patients with atrial flutter. We evaluated the risk of thromboembolism in 191 consecutive unselected patients referred for treatment of atrial flutter. A history of embolic events was noted in 11 patients. Acute embolism (<48 hours) occurred in 4 patients (3 after direct current cardioversion, 1 after catheter ablation). During follow-up of 26+/-18 months, 9 patients experienced thromboembolic events. During the follow-up, the overall embolic event rate (including acute embolism and thromboembolic events during follow-up) was 7 % in this patient population. Risk indicators for an embolic event in an univariate analysis were organic heart disease (p = 0.037), depressed left ventricular function (p = 0.02), history of systemic hypertension (p = 0.004), and diabetes mellitus (p = 0.0038). Using multivariate analysis, a history of hypertension was the only independent predictor for elevated embolic risk in this patient population (odds ratio = 6.5; 95% confidence intervals 1.5 to 45). Thus, the thromboembolic risk is higher than previously recognized for patients with atrial flutter. Anticoagulation therapy may decrease this risk.

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Authors: Seidl, K., Hauer, B., Schwick, N. G., Zellner, D., Zahn, R., & Senges, J.
Affiliations: Klinikum Ludwigshafen (DE)
Corresponding author: Seidl, Karlheinz
ORCID: Zahn, Ralf
Senges, Jochen
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 1998-09
Volume: 82
Issue: 5
Pages: 580-583
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/s0002-9149(98)00419-6
OpenAlex: W2023282715
Cited by: 135
References: 19
Citations by year: 2026: 1 · 2025: 1 · 2024: 2 · 2022: 4 · 2021: 2 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 4 · 2012: 8
FWCI: 6.32
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
Keywords: atrial flutter, thromboembolism, anticoagulation, hypertension, left ventricular function, organic heart disease, diabetes mellitus, cardioversion, catheter ablation, atrial fibrillation
MeSH terms: Aged, Anticoagulants, Atrial Flutter, Intracranial Embolism and Thrombosis, Electric Countershock, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Risk, Thromboembolism, Odds Ratio, Catheter Ablation

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Risk of thromboembolic events in patients with atrial flutter

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