CHA

Introduction: Typical atrial flutter (AFL) is associated with considerable morbidity and mortality despite high procedural success rates of cavotricuspid isthmus (CTI) ablation. While the CHA₂DS₂-VA score is widely used for thromboembolic risk assessment in atrial fibrillation, its prognostic value for long-term survival after CTI ablation remains unclear. Our objective therefore was to evaluate the association between the CHA₂DS₂-VA score, its individual components, and non-CHA₂DS₂-VA comorbidities with all-cause mortality following CTI ablation for typical AFL. Methods: We retrospectively analyzed clinical and mortality data from 249 consecutive patients who underwent successful CTI ablation between July 2017 and December 2021. Kaplan-Meier survival analysis, Cox regression, and time-dependent ROC analyses were performed to evaluate predictors of all-cause mortality. Results: During a mean follow-up of 1771 ± 635 days, 27% of patients died. Mortality increased progressively with higher CHA₂DS₂-VA scores, corresponding to a stepwise decline in survival (log-rank Discussion: The CHA₂DS₂-VA score is an independent predictor of long-term all-cause mortality after CTI ablation for typical AFL, extending its clinical utility beyond thromboembolic risk assessment. Incorporation of selected non-CHA₂DS₂-VA comorbidities may further refine risk stratification and support individualized follow-up strategies.