{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:45:56Z","timestamp":1762389956001,"version":"build-2065373602"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite guideline recommendations supporting catheter ablation for typical atrial flutter (AFL), there is a paucity of literature reporting the utilization and outcomes of ablation in tactical athletes. This study aims to characterize military personnel diagnosed with typical AFL and investigate the rates of catheter ablation and personnel returning to normal activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Military personnel diagnosed with typical AFL from 2016 to 2022 were analyzed and the management was reviewed. Typical AFL diagnoses were confirmed by electrocardiogram and electrophysiology study with entrainment or activation mapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty personnel (mean age, 40.7\u00b110.7 years; 98% male; mean BMI 28.3\u00b14.2 kg\/m2; mean left ventricular ejection fraction [LVEF] 58.3%\u00b17.7) were diagnosed with typical AFL. 34\/40 (85%) of service members diagnosed with typical AFL were retained on military status after diagnosis. Electrophysiology study and successful ablation was performed in 27\/40 (67.5%) of personnel with no complications. 26\/27 (96.3%) service members who underwent ablation were retained, whereas only 8\/13 (61.2%) service members who did not receive ablation were retained (P\u2009=\u2009.001, Figure 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Military tactical athletes with typical AFL receive safe and effective ablations. Ablation is associated with increases in military retention rates and return to normal activity when compared to treatment without ablation. These data support the use of ablation as first-line treatment for athletic populations with typical AFL. Future studies with a larger sample size should be performed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf242","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T09:16:02Z","timestamp":1747818962000},"page":"e2391-e2596","source":"Crossref","is-referenced-by-count":0,"title":["Catheter Ablation for Typical Atrial Flutter in Tactical Athletes"],"prefix":"10.1093","volume":"190","author":[{"given":"Matthew A","family":"Tunzi","sequence":"first","affiliation":[{"name":"Division of Cardiology, Brooke Army Medical Center , San Antonio, TX 78234,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto L","family":"Calaquian","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Brooke Army Medical Center , San Antonio, TX 78234,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6312-6434","authenticated-orcid":false,"given":"Kelvin N V","family":"Bush","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Brooke Army Medical Center , San Antonio, TX 78234,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"2025110519373780300_usaf242-B1","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1016\/S0735-1097(00)00982-7","article-title":"Incidence and predictors of atrial flutter in the general population","volume":"36","author":"Granada","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"2025110519373780300_usaf242-B2","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1177\/2047487313476414","article-title":"Atrial fibrillation in endurance athletes","volume":"21","author":"Wilhelm","year":"2014","journal-title":"Eur J Preventive Cardiol"},{"key":"2025110519373780300_usaf242-B3","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.ccep.2022.05.002","article-title":"Atrial flutter in particular patient populations","volume":"14","author":"Compagnucci","year":"2022","journal-title":"Cardiac Electrophysiol Clinics"},{"key":"2025110519373780300_usaf242-B4","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.echo.2017.11.009","article-title":"Atrial enlargement in the athlete\u2019s heart: assessment of atrial function may help distinguish adaptive from pathologic remodeling","volume":"31","author":"D\u2019 Ascenzi","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"2025110519373780300_usaf242-B5","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1093\/europace\/eux294","article-title":"The athlete\u2019s heart is a proarrhythmic heart, and what that means for clinical decision making","volume":"20","author":"Heidbuchel","year":"2018","journal-title":"Europace"},{"key":"2025110519373780300_usaf242-B6","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.eupc.2004.01.004","article-title":"Paroxysmal atrial fibrillation in male endurance athletes: a 9-year follow up","volume":"6","author":"Hoogsteen","year":"2004","journal-title":"Europace"},{"key":"2025110519373780300_usaf242-B7","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/eurheartj\/ehm555","article-title":"Sinus node disease and arrhythmias in the long-term follow-up of former professional cyclists","volume":"29","author":"Baldesberger","year":"2008","journal-title":"Eur Heart J"},{"key":"2025110519373780300_usaf242-B8","doi-asserted-by":"crossref","first-page":"i37","DOI":"10.1136\/bjsports-2012-091171","article-title":"Atrial fibrillation and atrial flutter in athletes","volume":"46","author":"Calvo","year":"2012","journal-title":"Br J Sports Med"},{"key":"2025110519373780300_usaf242-B9","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ijcard.2005.02.043","article-title":"Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter","volume":"107","author":"Heidb\u00fcchel","year":"2006","journal-title":"Int J Cardiol"},{"key":"2025110519373780300_usaf242-B10","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1136\/hrt.2010.216150","article-title":"Long-term endurance sport is a risk factor for development of lone atrial flutter","volume":"97","author":"Claessen","year":"2011","journal-title":"Heart"},{"key":"2025110519373780300_usaf242-B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-022-02542-8","article-title":"Characteristics of United States military pilots with atrial fibrillation and deployment and retention rates","volume":"22","author":"Keithler","year":"2022","journal-title":"BMC Cardiovascular Disorders"},{"key":"2025110519373780300_usaf242-B12","first-page":"1","volume-title":"Air Force Instruction 36-2905: Personnel Fitness Program","author":"Air Force","year":"2013"},{"year":"2025","author":"Driscoll D. 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