title: Characteristics of isolated atrial flutter versus atrial flutter combined with atrial fibrillation.
abstract: BACKGROUND
  Atrial flutter (AFL) and atrial fibrillation (AF) are "fellow-travellers". AF may be a stable, "isolated" rhythm, a bridge between sinus rhythm and AF, or both arrhythmias can coexist. Whether the characteristics of isolated AFL are different from those of patients with AFL combined with AF is still unclear.
  
  
  OBJECTIVE
  To compare the clinical characteristics of patients with isolated AFL to those of patients with AFL combined with AF, in a series of patients referred for AFL ablation.
  
  
  METHODS
  Seventy-six consecutive patients (mean age 66.9±12.2 years; 53 men) with a history of electrocardiogram-documented paroxysmal or persistent AFL, referred for catheter ablation, underwent clinical work-up including bidimensional echocardiogram. Patients were subdivided into group I (44 with isolated AFL) and group II (32 with AFL and a history of AF).
  
  
  RESULTS
  Underlying heart disease was present in 62 patients (81.6%). Hypertension was the most common cardiac disorder (n=44, 57.9%) and was more prevalent in group II than in group I (75.0% vs 45.5%; P=0.01). Prevalence of prior cardiac surgery was higher in group I (22.7% vs 6.3%; P=0.04). AFL was persistent in 35 group I patients and 17 group II patients (79.5% vs 53.1%; P=0.01). Class I or III antiarrhythmic drug use was more frequent in group II (84.4% vs 45.5%; P=0.001).
  
  
  CONCLUSIONS
  This study showed significant differences between patients with isolated AFL and those with AFL combined with AF, in the prevalence of underlying heart disease and the use of antiarrhythmic medication, which were higher when both atrial arrhythmias were combined. In turn, the history of cardiac surgery (including atriotomy), was more common in patients with isolated AFL than in those with AFL combined with AF.
authors: School of Medicine, université de La-Méditerrané, hôpital Nord, Division of Cardiology, Marseille, France. michael.peyrol@ap-hm.fr
authors: Michael
authors: M
authors: Peyrol
authors: Pascal
authors: P
authors: Sbragia
authors: Laurent
authors: L
authors: Bonello
authors: Samuel
authors: S
authors: Lévy
authors: Franck
authors: F
authors: Paganelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D015897:Comorbidity; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005602:France; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents