Comprehensive Analysis of Anticoagulant Therapy in Patients with Isolated Atrial Flutter

Authors

Andrey Ardashev, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA. Electronic address: ardashev1970@gmail.com.
Rod Passman, Division of Cardiology, Northwestern University, Chicago IL, USA. Electronic address: r-passman@northwestern.edu.
Irina Zotova, Healthcare Department, State Budget Healthcare Institution "City Hospital #17" of Moscow, Moscow, Russia. Electronic address: irinazotova@bk.ru.
Igor Efimov, Department of Biomedical Engineering, Northwestern University, Chicago IL, USA. Electronic address: igor.efimov@northwestern.edu.
Eric Rytkin, Department of Biomedical Engineering, Northwestern University, Chicago IL, USA. Electronic address: erytkin@northwestern.edu.
Gregory Trachiotis, Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA; Department of Surgery, The George Washington University Hospital, Washington, DC, USA; Department of Biomedical Engineering, The George Washington University, Washington,Gregory, DC, USA. Electronic address: Trachiotis@va.gov.
Bradley P. Knight, Division of Cardiology, Northwestern University, Chicago IL, Bradley, USA. Electronic address: Knight@nm.org.

Document Type

Journal Article

Publication Date

7-30-2024

Journal

The American journal of cardiology

DOI

10.1016/j.amjcard.2024.07.031

Keywords

antithrombotic therapy; atrial fibrillation; atrial flutter; deprescribing

Abstract

Limited comparative data exist regarding the risk of cardiogenic emboli in patients with isolated atrial flutter (AFL) Some studies suggest a lower complication risk in AFL compared to atrial fibrillation (Afib), but methodological limitations and conflicting reports necessitate a comprehensive investigation. Our analysis proposes that isolated AFL carries a lower risk of ischemic events and left atrial thrombus formation than AFib. Importantly, we caution against applying stroke risk assessment approaches designed for AFib to AFL patients, as it may lead to harmful overestimations and unnecessary anticoagulant prescriptions. Furthermore, we highlight the current lack of sufficient data to determine the overall clinical benefit of prolonged anticoagulant therapy in patients with isolated AFL, especially when CHA2DS2-VASc index values are below 4. This review challenges existing perceptions, offering insights into the nuanced risk profiles of the transitional nature of isolated AFL due to the high incidence of AFib development within a year of AFL diagnosis. Tailored risk assessments and further research are essential for precise clinical decision-making in this dynamic landscape.

APA Citation

Ardashev, Andrey; Passman, Rod; Zotova, Irina; Efimov, Igor; Rytkin, Eric; Trachiotis, Gregory; and Knight, Bradley P., "Comprehensive Analysis of Anticoagulant Therapy in Patients with Isolated Atrial Flutter" (2024). GW Authored Works. Paper 5216.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5216

Department

Surgery