The purpose of the study was to determine clinical and echocardiographic predictors of sinus rhythm maintenance in patients with typical atrial flutter (AFl) 6 months after cardioversion. We examined 96 patients with typical AFl: 80 (83.3 %) males and 16 (16.7 %) females, mean age 59.2±0.8 years. In 76 (79.2 %) patients sinus rhythm was restored by transesophageal stimulation, in 3 (3.1 %) cases – by electrical cardioversion. According to the sinus rhythm maintenance patients were divided into two groups: 1st (n=59) – sinus rhythm maintenance at 6 months after cardioversion, and 2nd (n=37) – recurrence of arrthythmia. The second group was characterized by significantly higher rates of coronary artery disease (52.5 vs 75.7 %; Р=0.03), arterial hypertension (40.1 % vs 67.6 %; Р=0.009) and concomitant atrial fibrillation (10.2 vs 75.7 %, Р<0.0001), higher tachycardia cycle length (247.0±3.3 vs 259.0±4.8 ms; Р=0.04) and lower A wave amplitude on the transesophageal electrogramme (16.3±0.7 vs 12.1±1.3; Р=0.01). In conclusion, patients with early recurrence of the AFl had significantly higher rate of concomitant cardiac diseases and electrophysiological remodeling of the atrium.