Does everyone with atrial flutter need ablation?

Question

Hi doctor,

I am a healthy individual with a normal sinus rhythm that I monitor twice daily. I had paroxysmal aflutter twice last year when I was stressed. I do not have comorbidities other than mild hypertension during the day. I take tablet Apixaban 5 mg twice daily and tablet Amlodipine 7.5 mg. My blood reports are normal. Nevertheless, my cardiologist recommends an ablation. Is it worth the risk? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

If the atrial aflutter is controlled by medicines, ablation is unnecessary. Ablation can be done if recurrent and bothersome symptoms are present despite medications. Ablation will not lessen the need for anticoagulation.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Anticoagulation need depends upon whether atrial fibrillation or flutter is valvular or nonvalvular. For valvular (mitral stenosis) anticoagulation is indicated. Echocardiography will diagnose mitral stenosis. If there is no mitral stenosis on echocardiography, an indication of anticoagulant depends upon risk factors. Risk factors include heart failure, hypertension, age 65 or more, diabetes, stroke, and vascular disease. Anticoagulation is indicated if two or more symptoms are present or only a positive stroke history. The need for anticoagulation depends upon the patient's preference and the symptom. If none of the above symptoms is present, an anticoagulation is not required.

I hope this helps.

Please revert so I can assist you further.

Thank you.