The characteristics of DM1 patients with atrial flutter (AFL) and their clinical outcome are unknown.

We retrospectively included the patients≥18 years of age with DM1 who were admitted in our institutions with AFL between January 2000 and September 2013 and analyzed their clinical outcome. We compared the incidence of AFL recurrences in patients who were treated with versus without radiofrequency (RF) ablation. Single and multiple variable analyses were performed to identify predictors of AFL recurrences.

We included 60 consecutive patients (age=41±13 years, male=34), including 55 with persistent, 2 with paroxysmal, and 3 permanent AFL. Over a 53±28 months mean follow-up duration, AFL recurrence occurred in 12 patients (24%), atrial fibrillation in 13 (26%), ischemic stroke in 2 (3%), cerebral hemorrhage in 1 (2%) and sinus node dysfunction in 4 (7%). Patients treated by RF ablation were significantly more frequently free of AFL recurrences by Kaplan Meier analysis (95% vs. 61%, HR=0.17, 95% CI 0.08 to 0.97, p=0.04). By multivariate analyses, RF ablation was the only parameter significantly associated with absence of AFL recurrence (p=0.01).

Patients with DM1 presenting with AFL are exposed to stroke, severe sinus node dysfunction and cerebral hemorrhage. RF catheter ablation is associated with a lower risk for AFL recurrences and may limit iatrogenic complications associated with pharmacological treatments.