Key result
Changes in the left atrial activation sequence produced significant changes in flutter wave polarity without altering the right atrial activation sequence in two patients with common atrial flutter.
Why the study?
Does the left atrial activation sequence affect flutter wave morphology in common atrial flutter?
Case Report (n=2)
Does the left atrial activation sequence affect flutter wave morphology in common atrial flutter?
Alterations in interatrial connections and left atrial activation sequence can produce atypical flutter wave morphologies in common atrial flutter.
Answers are grounded in this paper and cite their sources.
Flutter wave polarity interpretation requires caution due to left atrial influences; leaves open optimal mapping strategies for common flutter.
Whether the activation sequence of the right or left atrium plays a role in the morphology of the flutter wave in common atrial flutter is not completely understood. We present two patients with common counterclockwise atrial flutter in whom changes in the left atrial activation sequence produced significant changes in flutter wave polarity (+ to - and - to -/+ biphasic) without a change in the activation sequence within the right atrium. These cases highlight the possible role of alterations of the interatrial connections in the genesis of atypical manifestations of common atrial flutter.
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Ashino et al. (2007) conducted a case report in Common counterclockwise atrial flutter (n=2). Changes in the left atrial activation sequence was evaluated on Changes in flutter wave polarity. Changes in the left atrial activation sequence produced significant changes in flutter wave polarity without altering the right atrial activation sequence in two patients with common atrial flutter.
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