Catheter ablation is highlighted as a key therapeutic strategy for atrial flutter, particularly given the low success rate of long-term pharmacological antiarrhythmic approaches.
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May inform shared decision-making on ablation; leaves open need for randomized confirmation.
Atrial flutter (AFL) is one of the most common supraventricular arrhythmias in clinical practice.A significant number of patients with AFL will develop atrial fibrillation (AF) afterwards. 1 Moreover, a sizable proportion of patients who undergo AF ablation will develop AFL (atrial macroreentrant tachycardia is a more accurate term) as a secondary arrhythmia after the ablation procedure.Approaches to the management and use of anticoagulation therapy are considered equivalent for AFL and AF and the same stroke prevention strategies are therefore recommended. 2Appropriate management of AFL is not only important due the symptoms, but also to the increased risk of complications, such as thromboembolism and stroke, which may lead to permanent disability or death. 3So far, different therapeutic strategies have been introduced for AFL, including rate control, cardioversion to sinus rhythm (principally electrical cardioversion or high-rate stimulation), and catheter ablation. 4---6 Due to the low success rate of pharmacological antiarrhythmic approaches in AFL, long-term drug therapy is less acceptable nowadays, and is recommended
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Shamloo et al. (2020) studied this question.
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