Atrial flutter is a relatively rare arrhythmia in comparison to AF. Both arrhythmias share a very similar clinical profile, and often coexist within the same individual.

From: Contemporary Cardiology: Management of Cardiac Arrhythmias Edited by: L. I. Ganz © Humana Press Inc., Totowa, NJ

Because of their similarities, they are often combined together in studies reporting incidence and treatment efficacy. Therefore, there is insufficient independent data on the incidence of atrial flutter and its response to pharmacologic therapy. In one retrospective analysis of ICD-9 (i.e., billing) codes for atrial flutter in 54,000 patients in theMarshfield Epidemiologic Study Area, there was an annual incidence rate of 0.9 per 1000 patients. The annual incidence rate was 7.3 per 1000 patients greater than 80 yr of age. It is estimated that there are approx 200,000 new cases of atrial flutter in the United States per year (25).

Atrial flutter is commonly associated with AF, and may often coexist in some patients, occasionally simultaneously, manifesting as "flutter-fibrillation." Atrial flutter often complicates the postoperative management of patients who have undergone cardiac surgery. It has an association with chronic obstructive pulmonary disease (COPD), thyrotoxicosis, structural heart disease including mitral or tricuspid valve disease, atrial enlargement of any etiology, and surgical correction of congenital heart disease (26-29).

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