Risk of stroke in patients with atrial flutter

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Acknowledgements

We gratefully acknowledge David Rosenbaum, MD, for his critique, and Albert Waldo, MD, for his continued guidance.

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  • The 2020 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Comprehensive Guidelines for the Management of Atrial Fibrillation

    2020, Canadian Journal of Cardiology
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    In a metaregression analysis, the annual risk of stroke/systemic embolism was approximately 3% in patients with AFL.187 Although the rate of stroke is higher than that in control participants (HR, approximately 1.4), the risk of stroke appears to be lower than for patients with AF (HR, approximately 0.70).183,188 For AFL patients, the risk of stroke is higher with increasing CHA2DS2-VASc scores189-192 and also increased in patients who develop AF after their initial diagnosis of AFL.192

  • Comparative Risks of Ischemic Stroke in Atrial Flutter versus Atrial Fibrillation

    2018, Journal of Stroke and Cerebrovascular Diseases
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    There are few comparative data on the risks of ischemic stroke in atrial flutter versus atrial fibrillation. In a large observational study by Biblo et al, the risk of stroke in patients with atrial flutter appeared lower than the risk in patients with fibrillation, but the 2 conditions were not directly compared, and the study was limited by its exclusive use of inpatient claims data, which likely captured nongeneralizable cases of flutter and fibrillation.20 Other studies have reported that atrial flutter is associated with an increased risk of stroke and that this risk may be equivalent to the stroke risk in patients with atrial fibrillation, but these studies included relatively few cases of atrial flutter and thus may have lacked sufficient power to conclusively compare stroke risk in these closely related dysrhythmias.21-24

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