Comprehensive Analysis of Anticoagulant Therapy in Patients with Isolated Atrial Flutter.

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.

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Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rod Passman reports a relationship with Medtronic, Abbott, Johnson and Johnson, Funding from AHA, NIH, Abbott, and Royalties from UpToDate that includes: consulting or advisory. Dr Knight receives consulting fees from Abbott, Biosense Webster, Boston Scientific, Edwards, and Medtronic. Other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.