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Eur Heart J. 2015 Sep 14;36(35):2356-63. doi: 10.1093/eurheartj/ehv118. Epub 2015 Apr 2.

Atrial flutter: more than just one of a kind.

Author information

1
Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco sithi.bun@gmail.com.
2
Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco.
3
Cardiology Division, Section of Electrophysiology, University of Pennsylvania, USA.
4
Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco Cardiology Division, Section of Electrophysiology, University of Pennsylvania, USA.

Abstract

Since its first description about one century ago, our understanding of atrial flutter (AFL) circuits has considerably evolved. One AFL circuit can have variable electrocardiographic (ECG) manifestations depending on the presence of pre-existing atrial lesions, or impaired atrial substrate. Conversely, different (right sided or even left sided) atrial circuits including different mechanisms (macroreentrant, microreentrant, or focal) can present with a very similar surface ECG manifestation. The development of efficient high-resolution electroanatomical mapping systems has improved our knowledge about AFL mechanisms, as well as facilitated their curative treatment with radiofrequency catheter ablation. This article will review ECG features for typical and atypical flutters, and emphasize the limitations for circuit location from the surface ECG.

KEYWORDS:

Atypical atrial flutter; Cavotricuspid isthmus dependent; ECG; Typical atrial flutter

PMID:
25838435
DOI:
10.1093/eurheartj/ehv118
[Indexed for MEDLINE]

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