Variable electrocardiographic characteristics of isthmus-dependent atrial flutter

The purpose of this study was to characterize variations in flutter-wave (F-wave) morphology among patients with clockwise isthmus-dependent (CWID) and counterclockwise isthmus-dependent (CCWID) right atrial flutter (AFL) and to attempt to correlate F-wave morphology with echocardiographic data and...

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Veröffentlicht in:Journal of the American College of Cardiology 2002-09, Vol.40 (6), p.1125-1132
Hauptverfasser: Milliez, Paul, Richardson, Allison W, Obioha-Ngwu, Ogundu, Zimetbaum, Peter J, Papageorgiou, Panos, Josephson, Mark E
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container_issue 6
container_start_page 1125
container_title Journal of the American College of Cardiology
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creator Milliez, Paul
Richardson, Allison W
Obioha-Ngwu, Ogundu
Zimetbaum, Peter J
Papageorgiou, Panos
Josephson, Mark E
description The purpose of this study was to characterize variations in flutter-wave (F-wave) morphology among patients with clockwise isthmus-dependent (CWID) and counterclockwise isthmus-dependent (CCWID) right atrial flutter (AFL) and to attempt to correlate F-wave morphology with echocardiographic data and clinical patient characteristics. Variations in F-wave morphology on surface electrocardiogram (ECG) during CCWID and CWID flutter have been reported but never systematically characterized. Over a four-year period, 139 patients with AFL on ECG underwent electrophysiologic study and echocardiography at our institution. Electrocardiographic data, intracardiac recordings, echocardiographic data, and patient characteristics were reviewed retrospectively. Of 156 AFLs evaluated, 130 were CCWID, 26 were CWID. Three types of CCWID flutter were observed: type 1 had purely negative F-waves inferiorly, types 2 and 3 had F-waves inferiorly with small (type 2) or broad (type 3) positive terminal deflections; CCWID flutter types 2 and 3 were associated with higher incidence of left atrial (LA) enlargement, heart disease, and atrial fibrillation (Afib) than type 1. Two types of CWID flutter were observed: type 1 had notched positive F-waves with a distinct isoelectric segment inferiorly. Type 2 had broader F-waves inferiorly with positive and negative components and a short isoelectric segment. Variable ECG patterns for CCWID and CWID AFL exist. A positive component of the F-wave in the inferior leads during CCWID flutter is associated with an increased likelihood of heart disease, Afib, and LA enlargement.
doi_str_mv 10.1016/S0735-1097(02)02070-3
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Variations in F-wave morphology on surface electrocardiogram (ECG) during CCWID and CWID flutter have been reported but never systematically characterized. Over a four-year period, 139 patients with AFL on ECG underwent electrophysiologic study and echocardiography at our institution. Electrocardiographic data, intracardiac recordings, echocardiographic data, and patient characteristics were reviewed retrospectively. Of 156 AFLs evaluated, 130 were CCWID, 26 were CWID. Three types of CCWID flutter were observed: type 1 had purely negative F-waves inferiorly, types 2 and 3 had F-waves inferiorly with small (type 2) or broad (type 3) positive terminal deflections; CCWID flutter types 2 and 3 were associated with higher incidence of left atrial (LA) enlargement, heart disease, and atrial fibrillation (Afib) than type 1. Two types of CWID flutter were observed: type 1 had notched positive F-waves with a distinct isoelectric segment inferiorly. Type 2 had broader F-waves inferiorly with positive and negative components and a short isoelectric segment. Variable ECG patterns for CCWID and CWID AFL exist. A positive component of the F-wave in the inferior leads during CCWID flutter is associated with an increased likelihood of heart disease, Afib, and LA enlargement.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(02)02070-3</identifier><identifier>PMID: 12354439</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Atrial Flutter - diagnostic imaging ; Atrial Flutter - physiopathology ; Atrial Function, Right - physiology ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiology ; Cardiovascular disease ; Catheters ; Coronary vessels ; Echocardiography ; Electrocardiography ; Electrocardiography. 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Type 2 had broader F-waves inferiorly with positive and negative components and a short isoelectric segment. Variable ECG patterns for CCWID and CWID AFL exist. A positive component of the F-wave in the inferior leads during CCWID flutter is associated with an increased likelihood of heart disease, Afib, and LA enlargement.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial Flutter - diagnostic imaging</subject><subject>Atrial Flutter - physiopathology</subject><subject>Atrial Function, Right - physiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Catheters</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Electrocardiography. Vectocardiography</subject><subject>Electrodiagnosis. 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Type 2 had broader F-waves inferiorly with positive and negative components and a short isoelectric segment. Variable ECG patterns for CCWID and CWID AFL exist. A positive component of the F-wave in the inferior leads during CCWID flutter is associated with an increased likelihood of heart disease, Afib, and LA enlargement.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12354439</pmid><doi>10.1016/S0735-1097(02)02070-3</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Atrial Flutter - diagnostic imaging
Atrial Flutter - physiopathology
Atrial Function, Right - physiology
Biological and medical sciences
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Catheters
Coronary vessels
Echocardiography
Electrocardiography
Electrocardiography. Vectocardiography
Electrodiagnosis. Electric activity recording
Female
Heart
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Humans
Hypertension
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Patients
Retrospective Studies
Sensitivity and Specificity
title Variable electrocardiographic characteristics of isthmus-dependent atrial flutter
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