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Europace Advance Access originally published online on February 7, 2008
Europace 2008 10(3):284-288; doi:10.1093/europace/eun012
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

ELECTROPHYSIOLOGY

Clinical and electrophysiological characteristics of patients having atrial flutter with 1:1 atrioventricular conduction

Mihoko Kawabata*, Kenzo Hirao, Kouji Higuchi, Takeshi Sasaki, Toshiyuki Furukawa, Hiroyuki Okada, Hitoshi Hachiya and Mitsuaki Isobe

Department of Cardiovascular Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan

Aims: The purpose of this retrospective study was to assess characteristics of patients who had suffered atrial flutter (AFL) with 1:1 atrioventricular (AV) conduction (1:1 AFL).

Methods and results: Subjects were 8 patients (61 ± 14 years) with documented 1:1 AFL, and 101 AFL patients without a history of 1:1 AFL (control patients). 1:1 AFL occurred during physical activity with a ventricular rate of 218 ± 18 bpm. Antiarrhythmic agents were administered to all eight 1:1 AFL patients, whereas AV nodal conduction-suppressing agents were administered to four. The maximum ventricular rate at which 1:1 AV conduction occurred was significantly lower than when spontaneous 1:1 AFL occurred (164 vs. 218 bpm, P < 0.05). The 1:1 AFL patients had a significantly longer AFL cycle length (CL) (292 vs. 258 ms, P < 0.05) and more rapid AV nodal conduction time (maximum 1:1 AV conduction: 375 vs. 464 ms, P < 0.05) than did control. Arrhythmia had occurred in patients with an AFL CL ≥ 250 ms and a CL of maximum 1:1 AV conduction ≤400 ms.

Conclusion: Clinicians should be aware of the potential for 1:1 AV conduction in AFL patients, especially in those with remarkable prolongation of the CL in addition to enhanced AV conduction.

Key Words: Atrial flutter, 1:1 AV conduction, Syncope, Exercise, Sympathetic tone

* Corresponding author. Tel: +81 358035231; fax: +81 358030131.E-mail address: mihoko_kawabata.cvm{at}tmd.ac.jp

Manuscript submitted 15 October 2007. Accepted after revision 7 January 2008.


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