Atrial pacing successfully interrupted atrial flutter when the atria were paced at a rate too fast for the flutter to follow, requiring a mean of 10 seconds of constant rate pacing.
Observational (n=30)
Does atrial pacing interrupt atrial flutter in patients following open heart surgery?
Atrial flutter can be successfully interrupted by pacing at a rate faster than the flutter can follow, providing mechanistic insights into entrainment and termination of the arrhythmia.
To examine the question of why the pacing rate and duration of atrial pacing are crucial factors in the successful interruption of atrial flutter, studies were performed on 30 patients in the period following open heart surgery. In each patient the diagnosis of atrial flutter was made using a pair of wire electrodes placed on the right atrial epicardium at the time of operation and brought out through the anterior chest wall. The same electrodes were used for atrial pacing. Pacing faster than the spontaneous rate of the atrial flutter which failed to interrupt the atrial flutter was associated with transient entrainment of the atrial flutter up to the atrial pacing rate. Atrial flutter was interrupted successfully when the atria were paced at a rate which was too fast for the atrial flutter to follow. This was heralded by the conversion of previously negative flutter waves to positive atrial complexes in ECG lead II. When pacing the atria at a constant rate, 2-22 seconds with a mean of 10 seconds were required to interrupt the atrial flutter.
Waldo et al. (1977) conducted an observational in Atrial flutter (n=30). Atrial pacing was evaluated on Interruption of atrial flutter. Atrial pacing successfully interrupted atrial flutter when the atria were paced at a rate too fast for the flutter to follow, requiring a mean of 10 seconds of constant rate pacing.
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