PREVALENCE OF LEFT ATRIAL THROMBOSIS IN PATIENTS WITH ATRIAL FLUTTER

Abstract

Background: Little is known about the prevalence of atrial thrombosis in atrial flutter undergoing cardioversion of rhythm. Several studies, however, have shown that patients with atrial fibrillation have a high prevalence of atrial thrombosis, strongly associated with increased risk of embolism in atrial fibrillation. Still, the incidence of atrial thrombi in patients with atrial flutter is not well established.<br />Methods: Transesophageal echocardiography was done in 30 consecutive non-anticoagulated patients with a mean age of 48.4 years who were admitted for cardioversion of atrial flutter. Mean left atrial size was 4.3cm and mean ejection fraction was 42%. The mean duration of flutter was more than 48 hours. Left atrial thrombus was seen in 2 patients.<br />Results: Two patients had left atrial thrombosis and both of them had rheumatic mitral stenosis. The other patients were free of thrombosis.<br />Conclusion: This study suggests that atrial thrombus is uncommon in patients with atrial flutter, and there is a low risk of thromboembolism after cardioversion, except in rheumatic mitral stenosis, which itself has a high prevalence of left atrial thrombosis.