Catheter ablation (CA) is the preferred treatment approach for typical AFL due to its excellent long-term success rate. Further studies examining rhythm-guided OAC can minimize unnecessary exposure to long-term anticoagulation.Ĭavotricuspid isthmus-dependent atrial flutter (AFL) is a commonly encountered arrhythmia and a well-recognized risk factor for cardioembolic stroke. The benefit of continued OAC in this cohort may be outweighed by an adverse risk of bleeding. In patients undergoing successful AFL ablation, a strategy of OAC discontinuation with close rhythm monitoring appears feasible. There were a total of three major bleeding events, all in the OAC group. Over a mean follow-up period of 28.6 ± 27.3 months, there was one ischemic stroke in the OAC discontinuation group and no ischemic events in the continued OAC group. OAC was discontinued by six weeks in 17% and at one year in 55.7% of patients, respectively, but was continued indefinitely in 44.3%. The mean CHA 2DS 2-VASc score was 3 ± 1 points. A total of 106 patients were included in our analysis, with a mean age of 64 ± 14 years and 78.3% of whom were male. In patients with low left ventricular ejection fraction or prior atrial fibrillation episodes, OAC was continued for six months with repeat Holter monitoring at six months. OAC was discontinued if there was no evidence of recurrence at six weeks. All patients continued OAC for at least six weeks post-CA and underwent 24-hour Holter monitoring. We conducted a retrospective study of all patients who underwent typical AFL ablation at our institute from 2011 to 2017. However, current guidelines recommend pursuing oral anticoagulation (OAC) based on established indices of stroke regardless of the perceived success of ablation. Catheter ablation (CA) of typical atrial flutter (AFL) is the preferred treatment for typical AFL due to its excellent long-term success rate.
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