© 2002 by European Society of Cardiology
ATRIAL FLUTTER
Atypical atrial flutters
Centre Hospitalier Princess Grace Avenue Pasteur, 98012, Monaco
Abstract
Typical atrial flutter is due to a counterclockwise macrore-entry circuit localized in the right atrium with a surface ECG pattern showing predominantly negative F waves in the inferior leads and positive F waves in V1. Recently it has been proposed to classify atrial flutter on the basis of its cavo-tricuspid isthmus dependence rather than on the ECG pattern. Therefore some atrial flutters are considered typical even if the ECG does not exhibit a typical pattern. This is the case for reverse typical atrial flutter, lower loop re-entry and partial-isthmus-dependent short circuit flutter. The term atypical flutter refers to a non-isthmus dependent flutter. Usually these patients have had previous cardiac surgery with a right or left atriotomy. Flutter involving a spontaneous right atrial scar is not uncommon.
Key Words: Atrial flutter, common atrial flutter, typical atrial flutter, atypical atrial flutter, cavotricuspid isthmus re-entry arrhythmia, atrial scars
Correspondence: Nadir Saoudi MD, Centre Hospitalier Princesse Grace, Avenue Pasteur, 98012 Monaco (Principauté). Fax: 377 97 98 96 90; E-mail: nsaoudi{at}chpg.mc
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