CoChat
Sign Up
Cited by 12Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

Development and Validation of Diagnostic Criteria for Atrial Flutter on the Surface Electrocardiogram

Open access
Weinberg, Kenneth M., Denes, Pablo, Kadish, Alan H., Goldberger, Jeffrey J.·2008·Annals of Noninvasive Electrocardiology
DOI 10.1111/j.1542-474x.2008.00214.xPMC PMC6932105
Open this paper in CoChat — free account

Abstract

Background: There are no universally accepted ECG diagnostic criteria for atrial flutter (AFL), making its differentiation from “coarse” atrial fibrillation (AF) difficult. Methods: To develop diagnostic criteria for AFL, we examined two sets of ECGs. Set 1 consisted of 100 ECGs (50 AF, AFL) with diagnoses confirmed by intracardiac recordings. Criteria evaluated were presence of F waves in the frontal plane leads, F waves in V 1 , sawtooth F waves, rate, and regularity of ventricular response. Set 2 included 200 ECGs taken from the hospital database each of which had already been interpreted by a cardiologist as either AF (n = 100) or AFL (n = 100). Set 2 was blindly read by electrophysiologists whose consensus‐diagnoses were compared to the diagnoses made by using the best criteria identified from the Set 1 data. Results: The criteria of frontal plane F waves, regular or partially regular ventricular response, and their combination had sensitivities of 92%, 98%, and 90% and specificities of 100%, 78%, and 100% in Set 1 for the diagnosis of AFL. In Set 2, concordance of electrophysiologist and cardiologist diagnoses was only 84%. The criteria of frontal plane Fwaves, regular or partially regular ventricular response, and their combination resulted in concordances with the cardiologist diagnoses of 85%, 85%, and 82% and with the electrophysiologist‐consensus diagnoses of 90%, 89%, and 94% (P < 0.001). Conclusions: The criteria of frontal plane F waves and regular or partially regular ventricular response aid in the proper diagnosis of AFL. Because management strategies may differ for AF and AFL, it is important to adopt a more rigorous diagnostic approach.

Integrity signals

Registry

Crossref · 10.1111/j.1542-474x.2008.00214.x

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The criteria of frontal plane F waves is the best diagnostic criteria for atrial flutter on the surface ECG.

    “The criteria of frontal plane F waves was found to be the best diagnostic criteria for atrial flutter on the surface ECG. 14”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [14]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Weinberg, K. M., Denes, P., Kadish, A. H., & Goldberger, J. J.
Affiliations
Northwestern University (US)
ORCID
Venue
Annals of Noninvasive Electrocardiology
Publisher
Wiley
Published
2008-04
Volume
13
Issue
2
Pages
145-154
ISSN
  • 1082-720X (ISSN-L)
  • 1542-474X
DOI
10.1111/j.1542-474x.2008.00214.x
PMC
PMC6932105
OpenAlex
W2074194636
Cited by
12
References
19
Citations by year
2026: 3 · 2016: 1 · 2013: 1
FWCI
1.46
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 17 d)
Locations
  • Annals of Noninvasive Electrocardiology (publishedVersion)
  • PubMed Central (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, atrial fibrillation, F-wave, sensitivity and specificity, interobserver agreement
MeSH terms
Adult, Aged, Atrial Fibrillation, Atrial Flutter, Diagnosis, Differential, Electrocardiography, Female, Humans, Male, Middle Aged, Probability, Sensitivity and Specificity, Cohort Studies, Validation Studies as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review