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

Autor: Ardashev A; Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago IL, USA. Electronic address: ardashev1970@gmail.com., Passman R; Division of Cardiology, Northwestern University, Chicago IL, USA., Zotova I; Healthcare Department, State Budget Healthcare Institution 'City Hospital #17' of Moscow, Moscow, Russia., Efimov I; Department of Biomedical Engineering, Northwestern University, Chicago IL, USA., Rytkin E; Department of Biomedical Engineering, Northwestern University, Chicago IL, USA., Trachiotis G; 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, DC, USA., Knight BP; Division of Cardiology, Northwestern University, Chicago IL, USA.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Nov 01; Vol. 230, pp. 72-81. Date of Electronic Publication: 2024 Jul 31.
DOI: 10.1016/j.amjcard.2024.07.031
Abstrakt: 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. In conclusion, tailored risk assessments and further research are essential for precise clinical decision-making in this dynamic landscape.
Competing Interests: Declaration of competing interest Dr. Knight receives consulting fees from Abbott, Biosense Webster, Boston Scientific, Edwards, and Medtronic. Dr Passman is on the Advisory boards: Medtronic, Abbott, Johnson & Johnson, iRhythm Royalties: UpToDate. Other authors declare no relevant disclosures regarding this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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