Key result
Atrial flutter ablation and restoration of sinus rhythm reduced severe mitral regurgitation velocity from 599 cm/s to 450 cm/s at 3 weeks, and to trace levels at 2 years.
Why the study?
Atrial functional mitral regurgitation is known to be related to atrial fibrillation, but the relationship between atrial flutter and mitral regurgitation remains underexplored.
Does atrial flutter ablation improve mitral regurgitation severity in patients with atrial flutter and severe MR?
Case Report (n=1)
Does atrial flutter ablation improve mitral regurgitation severity in patients with atrial flutter and severe MR?
Atrial flutter ablation can lead to rapid and sustained improvement in severe atrial functional mitral regurgitation, independent of left atrial reverse remodeling.
Answers are grounded in this paper and cite their sources.
Atrial flutter may contribute to reversible severe MR; hypothesis-generating and leaves open prospective confirmation before practice change.
Mitral regurgitation (MR) is a common valvular dysfunction often classified as primary or secondary, with the latter typically associated with left ventricular dysfunction or mitral annular dilation. A subset of MR is termed atrial functional MR, related to atrial fibrillation, but the relationship between atrial flutter and MR remains underexplored. This report describes the case of a 71-year-old man with severe MR and atrial flutter who experienced rapid improvement in MR severity following successful atrial flutter ablation and restoration of sinus rhythm. Initial echocardiography revealed severe left atrial dilation, moderate to severe eccentric MR, and moderate tricuspid regurgitation. Following ablation, MR severity significantly improved despite persistent left atrial dilation, with sustained improvement observed over two years alongside reverse remodeling of the left atrium. This case highlights the independent effect of atrial flutter on MR severity, separate from structural remodeling, and emphasizes the potential for rhythm control strategies to improve MR and avoid invasive valve interventions. It also raises important questions about the interplay between atrial arrhythmias and MR, underscoring the need for further studies to better understand atrial functional MR and its management.
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Eldawud et al. (2025) conducted a case report in Severe mitral regurgitation and atrial flutter (n=1). Atrial flutter ablation was evaluated on Mitral regurgitation severity. Atrial flutter ablation and restoration of sinus rhythm reduced severe mitral regurgitation velocity from 599 cm/s to 450 cm/s at 3 weeks, and to trace levels at 2 years.
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