AI Article Synopsis
- Atrial flutter (AFL) is an arrhythmia characterized by a reentrant circuit causing a "sawtooth" pattern on electrocardiograms, with left atrial depolarization leading to a specific wave pattern.
- Researchers hypothesized that interrupting the circuit in the heart could stop this depolarization and alter the electrocardiogram pattern.
- In a study of 100 AFL cases undergoing radiofrequency ablation, 17 cases confirmed that the sharp negative deflection in flutter waves is linked to left atrial depolarization, as they observed a change in the waveform after successful treatment.
Article Abstract
Background: Typical atrial flutter (AFL) is a macroreentrant arrhythmia characterized by a counterclockwise circuit that passes through the cavotricuspid isthmus with passive depolarization of the left atrium. These electrical events are thought to be responsible for the classic "sawtooth" wave of atrial flutter seen on the surface electrocardiogram characterized by a gradual downward deflection followed by a sharp negative deflection. It has been suggested that the negative flutter wave is a result of passive depolarization of the left atrium. We hypothesized that interruption of the circuit within the isthmus would prevent the reentrant wave from depolarizing the left atrium thus eliminating the component of the electrocardiogram reflecting left atrial depolarization.
Methods: We examined 100 cases of atrial flutter with the typical "sawtooth" pattern referred for radiofrequency ablation. Ninety-seven of the 100 were successfully ablated. All cases were reviewed for termination of atrial flutter with the last intracardiac electrogram just lateral to the site of linear ablation and surface flutter wave at the moment of termination not obscured by the QRS segment or the T-wave. Seventeen of the 97 met these criteria.
Results: Seventeen of the 17 cases demonstrated a gradual negative deflection as the last discernible wave of atrial activity followed by an isoelectric period and resumption of normal sinus rhythm. The last generated wave lacked the sharp negative downstroke.
Conclusion: These results suggest that the sharp negative deflection of flutter waves likely correlates with the wavefront's penetration of the interatrial septum and passive depolarization of the left atrium.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932011 | PMC |
| http://dx.doi.org/10.1111/j.1542-474X.2004.94576.x | DOI Listing |
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