Do different atrial flutter types carry the same thromboembolic risk?
Thromboembolic risk of atrial flutter (AFl) types has not been elucidated sufficiently in previous reports. The authors classified the patients according to surface electrocardiogram and electrophysiologic characteristics as those with typical AFl (37 patients, 78.4% male, mean age 59.8 +/-9.5 years) and atypical AFl (13 patients, 69.2% male, mean age 60.9 +/-6.9 years) and compared them regarding some clinical, echocardiographic, and hematologic parameters. An age- and gender-matched control group composed of 20 individuals without any organic heart disease in sinus rhythm was chosen (80% male, mean age 60.3 +/-7.9 years). Clinical features such as age, gender, organic heart disease, hypertension, diabetes mellitus, AFl duration, and the prevalence of paroxysmal atrial fibrillation were similar in both AFl groups. Echocardiographic parameters such as left ventricular ejection fraction, left atrial (LA) diameter, LA spontaneous echo contrast, and LA appendage emptying velocities were similar in both AFl groups. Fibrinogen, fibrin D-dimer, and thrombin-antithrombin III levels reflecting coagulation system activity were found to be increased in the patients with atypical AFl when compared with those with typical AFl and the control group (p < 0.001). In Pearson's correlation analysis, significant correlation between these hematologic markers and clinical and echocardiographic parameters were not found (p > 0.05). The coagulation system activity was found to be increased in patients with atypical AFl. Thus, anticoagulation due to the increased thromboembolic risk should be considered in patients with atypical AFl.
Demir
Ahmet Duran
AD
Department of Cardiology at Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. demirad@ixir.com
Soylu
Mustafa
M
Ozdemir
Ozcan
O
Topaloğlu
Serkan
S
Aras
Dursun
D
Saşmaz
Ali
A
Korkmaz
Sule
S
D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001282:Atrial Flutter / Q000145:classification* / Q000150:complications*; D001778:Blood Coagulation Disorders / Q000150:complications; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013923:Thromboembolism / Q000209:etiology*
D000925:Anticoagulants