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Early flutter mechanism debate persists; leaves open modern high-resolution mapping validation.
The mechanism of post-stimulatory atrial flutter has been extensively studied during the past 50 years. Rothberger and Winterberg (1914) believed that it was due to a rapidly discharging ectopic focus, while Lewis (1920) and Lewis, Feil, and Stroud (1920) ascribed it to a circus move- ment mechanism around the orifices of the two venae cavae with the impulse circulating in a clockwise or anticlockwise direction. Lewis, Drury, and Iliescu (1921b) also studied clinical atrial flutter and concluded that the circus movement mechanism was fully applicable in these cases.
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P L Sharma (1963) studied this question.
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