A review of typical and atypical atrial flutters highlights that different atrial circuits can present with similar surface ECG manifestations, limiting the ability to locate circuits from ECG alone.
Since its first description about one century ago, our understanding of atrial flutter (AFL) circuits has considerably evolved. One AFL circuit can have variable electrocardiographic (ECG) manifestations depending on the presence of pre-existing atrial lesions, or impaired atrial substrate. Conversely, different (right sided or even left sided) atrial circuits including different mechanisms (macroreentrant, microreentrant, or focal) can present with a very similar surface ECG manifestation. The development of efficient high-resolution electroanatomical mapping systems has improved our knowledge about AFL mechanisms, as well as facilitated their curative treatment with radiofrequency catheter ablation. This article will review ECG features for typical and atypical flutters, and emphasize the limitations for circuit location from the surface ECG.
Bun et al. (Thu,) conducted a review in Atrial flutter. A review of typical and atypical atrial flutters highlights that different atrial circuits can present with similar surface ECG manifestations, limiting the ability to locate circuits from ECG alone.