SHAHEED RAJAIE CARDIOVASCULAR, MEDICAL AND RESEARCH CENTER, MELLAT PARK, TEHRAN, 19947, IRAN
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.
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.
Results: Two patients had left atrial thrombosis and both of them had rheumatic mitral stenosis. The other patients were free of thrombosis.
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.