Incidence and predictors of atrial flutter in the general population

OBJECTIVES The goal of our study was to determine the incidence and predict ors of atrial flutter in the general population. BACKGROUND Although atrial flutter can now be cured, there are no reports o n its epidemiology in unselected patients. METHODS The Marshfield Epidemiological Study Area (MESA), a database that c aptures nearly all medical care among its 58,820 residents was used to asce rtain all new cases of atrial flutter diagnosed from July 1, 1991 to June 3 0, 1995. To identify predisposing risk factors, we employed an age- and gen der-matched case-control study design using eight additional variables. RESULTS A total of 181 new cases of atrial flutter were diagnosed for an ov erall incidence of 88/100,000 person-years. Incidence rates ranged from 5/1 00,000 in those <50 years old to 587/100,000 in subjects older than 80. Atr ial flutter was 2.5 times more common in men (p < 0.001). The risk of devel oping atrial flutter increased 3.5 times (p < 0.001) in subjects with heart failure and 1.9 times (p < 0.001) for subjects with chronic obstructive pu lmonary disease. Among those with atrial flutter 16% were attributable to h eart failure and 12% to chronic obstructive lung disease. Three subjects (1 .7%) without identifiable predisposing risks were labeled as having "lone a trial flutter". CONCLUSIONS This study, the first population-based investigation of atrial flutter, suggests this curable condition is much more common than previousl y appreciated. If our findings were applicable to the entire U.S. populatio n, we estimate 200,000 new cases of atrial flutter in this country annually . At highest risk of developing atrial flutter are men, the elderly and ind ividuals with preexisting heart failure or chronic obstructive lung disease . (C) 2000 by the American College of Cardiology.