LAUSR

BACKGROUND The CHADS2 and CHA2DS2-VASc scores were shown to predict mortality in atrial fibrillation patients. However, both pathophysiology and treatment outcomes of atrial fibrillation and typical atrial flutter (AFL) differ. Consequently, prognosis in AFL patients might also be different. AIMS To assess CHADS2 and CHA2DS2-VASc scores as mortality predictors in patients with typical AFL. METHODS Large cohort of consecutive patients with typical AFL who underwent catheter ablation was retrospectively analyzed. The CHADS2 and CHA2DS2-VASc were calculated using hospital record data. All-cause mortality data was obtained from the national PESEL registry. Kaplan-Meier method and multivariate Cox proportional hazard models were applied for survival and hazard ratio analysis, respectively. RESULTS A total of 469 patients hospitalized for typical AFL ablation were enrolled (age: 63.7±12.2 years; male sex: 69.1%). Patients were followed from 2 to 12 years resulting in 2974 patient-years of follow-up. Kaplan-Meier survival analysis revealed a significant negative impact from  each component of the CHADS2 and CHA2DS2-VASc scores on survival with the exception of stroke (not significant) and the female gender (related to a better survival). Consequently, higher scores were predictive of higher all-cause  mortality (ranging from 2.7% to 54% at 10 years); the CHA2DS2-VASc was not more predictive than CHADS2 score. CONCLUSIONS In patients referred for typical AFL ablation, the CHADS2 score can be applied for prognosis assessment. A successful AFL ablation procedure should not divert the attention from recognizing and addressing other medical issues that have an impact on long-term mortality, which remains very high in this particular population.