The prevalence and the incidence of atrial flutter in patients with myotonic dystrophy type 1 (DM1) and the most appropriate strategies for its management are unknown. Atrial flutter is a common manifestation of this disease, potentially complicated by arterial thromboembolism or severe bradyarrhythmias.
In this article, a team of french clinicians retrospectively included in the DM1 Heart Registry 929 adult patients with DM1 admitted to our Institutions between January 2000 and September 2013. They selected patients presenting with atrial flutter and analysed data relative to the occurrence of arterial thromboembolism, severe bradyarrhythmias and atrial flutter recurrences. Atrial flutter was present in 79 of the 929 patients included in our Registry, representing a 8.5% prevalence. Patients with atrial flutter were older, had a higher muscular disability rating scale score and had higher prevalence of other cardiac manifestations of DM1. Sixty patients presented with a first episode of atrial flutter, representing a 4.6% incidence. Severe bradyarrhythmias requiring permanent pacing were present in 4 patients. Long-term follow-up (over 7 years for some patients) brings a significant numbers of complications, including ischemic disorders. Authors conclude that radiofrequency catheter ablation is associated with a lower risk for recurrences.
