title: Thromboembolic risk in atrial flutter. The FLASIEC (FLutter Atriale Società Italiana di Ecografia Cardiovascolare) multicentre study.
abstract: OBJECTIVE
  Patients with atrial flutter are believed to be at lower risk of thromboembolism than patients with atrial fibrillation. However, the incidence of atrial thrombi and the need for anticoagulation in patients with atrial flutter is not well established.
  
  
  RESULTS
  A prospective observational multicentre study was undertaken to assess the frequency of atrial thrombi and spontaneous echocontrast and the prevalence for aortic complex atherosclerotic lesions in a cohort of unselected patients with atrial flutter. We evaluated 134 patients (102 male, aged 70+/-9 years); exclusion criteria were history of atrial fibrillation, rheumatic mitral valve disease and mitral mechanical prosthesis. The median of atrial flutter duration was 33 days. Twelve patients had been taking warfarin for more than 7 days. One hundred and twenty-four patients (94%) underwent a transoesophageal echocardiogram, which revealed left atrial appendage thrombi in two patients (1.6%) and right atrial thrombi in one patient (1%). At least moderate left atrial echocontrast was found in 16/124 patients (13%). Complex atherosclerotic aortic plaques were detected in 10 patients (8%). Atrial flutter conversion was attempted in 93/134 patients (69%). At the 1-month follow-up, two patients experienced a thromboembolic event following restoration of sinus rhythm.
  
  
  CONCLUSIONS
  Atrial thrombi and echocontrast, and complex aortic atherosclerotic plaques are relatively uncommon in patients with atrial flutter. Post-cardioversion embolism was observed in two patients in our study population.
authors: Unità Operativa di Cardiologia, Ospedale Generale Valduce, Como, Italy.
authors: G
authors: G
authors: Corrado
authors: A
authors: A
authors: Sgalambro
authors: A
authors: A
authors: Mantero
authors: F
authors: F
authors: Gentile
authors: M
authors: M
authors: Gasparini
authors: R
authors: R
authors: Bufalino
authors: A
authors: A
authors: Morabito
authors: G
authors: G
authors: Trocino
authors: R
authors: R
authors: Schiavina
authors: S
authors: S
authors: Mandorla
authors: R
authors: R
authors: Mangia
authors: D
authors: D
authors: Tovena
authors: K
authors: K
authors: Savino
authors: F
authors: F
authors: Jacopi
authors: E M
authors: EM
authors: Pellegrino
authors: F
authors: F
authors: Agostini
authors: G
authors: G
authors: Centonze
authors: F
authors: F
authors: Bovenzi
authors: E
authors: E
authors: Caprino
authors: G
authors: G
authors: Tadeo
authors: M
authors: M
authors: Santarone
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use*; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000000981:diagnostic imaging; D001282:Atrial Flutter / Q000150:complications / Q000000981:diagnostic imaging*; D019560:Echocardiography, Three-Dimensional; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013923:Thromboembolism / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D000925:Anticoagulants