Atrial flutter: more than just one of a kind
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.
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Left or right atrial macro-reentrant tachycardia is usually confined to patients after catheter ablation for AF, AF surgery, or after open heart surgery.
“Left or right atrial macro-reentrant tachycardia is usually confined to patients after catheter ablation for AF, AF surgery, or after open heart surgery.158”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [158]
Right atrial isthmus-dependent flutter has a typical ECG pattern and ventricular rate.
“Right atrial isthmus-dependent flutter has a typical ECG pattern and ventricular rate.158”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [158]
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References 61 · Cited by 115
- Authors
- Bun, S.-S., Latcu, D. G., Marchlinski, F., & Saoudi, N.
- Affiliations
- Princess Grace Hospital Centre (MC)
- University of Pennsylvania (US)
- Corresponding author
- Bun, Sok-Sithikun
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-04-02
- Volume
- 36
- Issue
- 35
- Pages
- 2356-2363
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2073569651
- Cited by
- 115
- References
- 61
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 11 · 2023: 19 · 2022: 15 · 2021: 10 · 2020: 4 · 2019: 12 · 2018: 7 · 2017: 10 · 2016: 9 · 2015: 1
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial flutter, electroanatomical mapping, radiofrequency catheter ablation, focal atrial tachycardia, atypical atrial flutter, atrial substrate
- MeSH terms
- Atrial Flutter, Cicatrix, Electrocardiography, Humans, Tachycardia, Atrial Function, Left, Catheter Ablation, Coronary Sinus
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