Abstract：
Limited comparative data exist regarding the risk of cardiogenic emboli in patients with isolated atrial flutter (AFL). Some studies suggest a lower complication risk in AFL than atrial fibrillation (Afib); however, methodologic limitations and conflicting reports necessitate a comprehensive investigation. Our analysis proposes that isolated AFL carries a lower risk of ischemic events and left atrial thrombus formation than AFib. Importantly, we caution against applying stroke risk assessment approaches designed for AFib to patients with AFL because it may lead to harmful overestimations and unnecessary anticoagulant prescriptions. Furthermore, we highlight the current lack of sufficient data to determine the overall clinical benefit of prolonged anticoagulant therapy in patients with isolated AFL, especially when CHA2DS2-VASc index values are below 4. This review challenges existing perceptions, offering insights into the nuanced risk profiles of the transitional nature of isolated AFL because of the high incidence of AFib development within a year of AFL diagnosis. Tailored risk assessments and further research are essential for precise clinical decision-making in this dynamic landscape.
摘要：
关于孤立性房扑（AFL）患者的心源性栓塞风险的比较数据有限。一些研究表明，与房颤（Afib）相比，AFL的并发症风险较低。但是方法上的局限性和相互矛盾的报告需要进行全面的调查。我们的分析表明，孤立的AFL比AFib具有更低的缺血事件和左心房血栓形成风险。重要的是,我们告诫不要将针对AFib设计的卒中风险评估方法应用于AFL患者，因为它可能导致有害的高估和不必要的抗凝剂处方。此外，我们强调，目前缺乏足够的数据来确定长期抗凝治疗对孤立性AFL患者的总体临床益处，特别是当CHA2DS2-VASc指数值低于4时。这篇评论挑战了现有的看法，由于AFL诊断后一年内AFib发展的发生率很高，因此提供了对孤立的AFL过渡性质的细微差别风险特征的见解。在这种动态环境中，量身定制的风险评估和进一步的研究对于精确的临床决策至关重要。
