This experimental study demonstrates that atrial flutter can arise from either a rapidly firing ectopic focus or a circus movement depending on the induction method, and these mechanisms can only be differentiated using direct cardiac leads.
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Distinguishes focal vs reentrant flutter by induction method in animals; leaves open human translation and direct-lead requirements.
The mechanism of atrial flutter induced by the local application of aconitine or by the Rosenblueth-Garcia Ramos method was studied in dogs. The results were analyzed from a pharmacologic and electrocardiographic point of view. It was concluded that aconitine-induced flutter is due to a single, rapidly firing ectopic focus and electrically-induced flutter to a circus movement. Although they can be differentiated electrocardiographically by means of direct cardiac leads, they cannot be differentiated by esophageal or limb leads.
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Lanari et al. (1956) studied this question.
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