The aim – to compare cardiovascular risk factors, clinical characteristics, myocardial structure and function in patients with isolated AFL to those in patients with AFL combined with AF; to summarize management data of hospitalized patients with atrial flutter in real-life clinical practice.
Material and methods. The study included 126 hospitalized patients with atrial flutter, 86 men (68.3 %) and 40 women (31.7 %), median age 65.5 (quartiles 55–73) years. All patients were divided into two groups. The first group consisted of 58 (46.0 %) patients with isolated AFL, second group – 68 (54.0 %) patients with AFL combined with AF. Cardiovascular risk factors, concomitant diseases, anthropometric data, laboratory and echocardiographic parameters were compared between two groups.
Results. Рatients with isolated AFL were older than patients with AFL combined with AF (69.5 (60–75) vs 60.5 (50.5–72.5), Р=0.003); more of them were males (46 (79.3 %) vs 40 (58.8 %), Р=0.02). No differences regarding prevalence of concomitant disease and cardiovascular risk factors in the compared groups were revealed, but significant prevalence of chronic lung disease in patients with isolated AFL. There was no significant differences between the CHA2DS2-VASc cardiovascular risk factors found [2.97 (1.48–4.5) vs 2.62 (1.31–4.3), Р=0.26]. Patients with AFL combined with AF had longer history of arrhythmias [84 (10–192) vs. 10 (1–48) weeks, Р=0.006]. Concomitant AF was significantly less common in patients with first-detected AFL (17 (29.3 %) versus 10 (14.7 %), Р=0.05). Warfarin use was less frequent in patients with isolated AFL (15 (25.9 %) versus 31 (45.6 %), Р=0.02), despite the same high cardiovascular risk of thromboembolic events in both groups.
Conclusions. AFL coexists with AF in 54 % of consecutively hospitalized patients. The results showed the difficulties of rhythm control in patients with AFL, high prevalence of concomitant diseases, high risk of thromboembolic events. Study showed underuse of anticoagulant therapy in patients with isolated AFL, low frequency of catheter ablation.