OBJECTIVE: The objective of the study was to analyze annual health resource utilization and costs of patients with atrial flutter. While the majority of atrial flutter research has focused on various pharmacologic, cardioversion, and catheter ablation treatment options, the costs associated with treating atrial flutter patients have not been previously reported. METHODS: All patients receiving a diagnosis of atrial flutter (ICD-9 427.32) between January 1, and December 31, 2002 were identified from a nationally representative private payer database (IHCIS, Waltham, MA). Patients <18 years of age or not continuously enrolled in a health plan for one year following the atrial flutter diagnosis were removed from the analysis. Total one-year health resource use and costs, including hospital inpatient, outpatient, professional, ancillary, and pharmacy services, were measured from a third-party payer perspective. RESULTS: The study included 4945 patients with an atrial flutter diagnosis. The average age was 62 years; 65% were male. The top co-morbid conditions were atrial fibrillation (72.3%), hypertension (55%), and neoplasms (27%). Average total one-year medical costs for atrial flutter patients were $25,652 +/- $44,814, of which inpatient hospitalizations comprised almost 50% of the total cost. Over half of patients were hospitalized with mean length of stay of 6.78 +/- 20.73 days, 83% had at least one outpatient visit, while almost all patients had a physician visit and 71% required at least one pharmacy visit during the one-year follow-up. CONCLUSION: Patients diagnosed with atrial flutter incur significant health care costs and resource utilization. This analysis of atrial flutter patients is the first step towards understanding the clinical and economic burden of the disease in the United States.