We performed retrospective analysis of 154 cases of first episode of non-valvular typical atrial flutter: 133 (86.4 %) men and 21 (13.6 %) women aged (55.4±0.9) years. Over 10 years of follow-up permanent atrial fibrillation or flutter was registered in 68.5% patients, rare paroxysms – in 24.7 % patients, frequent paroxysms (at least once per 3 months) – in 4.1 %, no arrhythmias – in 2.7 %. Drug cardioversion was effective in 16.7 % patients, drug combined with electric cardioversion (in case of medication inefficacy) – in 47.6 % patients, while only electric cardioversion (including transesophageal electric cardiac stimulation) – in 35.7 %. Frequent paroxysms occurrence didn’t change over 1, 5 and 10 years of follow-up and was registered in 6.2 % (4.1–8.3 %) patients. In 87 % of patients with preserved sinus rhythm no antiarrhythmic medication therapy was needed over 10-year period.