Dr. Smith's ECG Blog

DECEMBER 24, 2023

Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. Further history revealed she had new onset atrial flutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago.

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Atrial Flutter Blog Aortic Dysrhythmia 127

HeartRhythm

OCTOBER 21, 2024

While atrial arrhythmias are frequently associated with SSS, we hypothesized that atrial flutter (AFL) would strongly predict SSS given shared relationships with right atrial, and particularly crista terminalis, fibrosis.

Atrial Flutter 40

Atrial Flutter Quality of Life Pacemaker Arrhythmia 40

HeartRhythm

APRIL 30, 2024

While atrial arrhythmias are frequently associated with SSS, we hypothesized that atrial flutter (AFL) would strongly predict SSS given shared relationships with right atrial, and particularly crista terminalis, fibrosis.

Atrial Flutter 40

Atrial Flutter Quality of Life Pacemaker Arrhythmia 40

HeartRhythm

APRIL 11, 2024

Idiopathic atypical (non-cavotricupid isthmus [CTI]-dependent) atrial flutter (IAAFL) may be seen in patients without structural heart disease and without previous cardiac surgery or ablation.

Atrial Flutter 40

Atrial Flutter Ablation Outcomes Heart Disease 40

Frontiers in Cardiovascular Medicine

AUGUST 7, 2024

BackgroundTypical isthmus-dependent atrial flutter (AFL) is traditionally treated through radiofrequency (RF) ablation to create a bidirectional conduction block across the cavo-tricuspid isthmus (CTI) in the right atrium.

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Atrial Flutter Ablation Tricuspid 52

HeartRhythm

APRIL 30, 2024

Atrial flutter/atrial tachycardia (AFL/AT) detection performance in insertable cardiac monitors (ICM) remains a challenge due to inappropriate detections.

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Atrial Flutter Tachycardia 40

HeartRhythm

SEPTEMBER 12, 2024

Traumatic brain injury (TBI) is associated with a variety of adverse long-term outcomes and increases sympathetic nervous system activation which could increase the risk of arrhythmias including atrial fibrillation or atrial flutter (AF/AFL).

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Atrial Flutter Atrial Fibrillation Arrhythmia Outcomes 40

HeartRhythm

APRIL 30, 2024

Atypical Atrial Flutter (AAFL) prevalence is increasing due to the escalating Atrial Fibrillation (AF) ablations and cardiac surgeries. We wanted to explore the outcome of the AAFL ablation, considering the recent changes in mapping and ablation.

Atrial Flutter 40

Atrial Flutter Ablation Electrophysiology Atrial Fibrillation 40

Journal of Cardiovascular Electrophysiology

DECEMBER 2, 2024

ABSTRACT Background Atrial fibrillation and atrial flutter are relatively rare in young people and the incidence of thromboembolic complications is unknown. These issues contribute to the limited utility of present guidelines regarding anticoagulation in this population.

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Atrial Flutter Atrial Fibrillation Pediatrics AFIB 40

HeartRhythm

APRIL 30, 2024

Cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) is one of the most common atrial arrhythmias involving the right atrium (RA). Radiofrequency catheter ablation has been widely used as a therapy of choice and it is curative.

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Atrial Flutter Ablation Tricuspid Arrhythmia 40

Journal of Cardiovascular Electrophysiology

JANUARY 17, 2025

ABSTRACT Atrial flutter (AFL), defined as macro-re-entrant atrial tachycardia, is associated with debilitating symptoms, stroke, heart failure, and increased mortality. Atypical AFL is a heterogenous group of re-entrant atrial tachycardias that most commonly occur in patients with prior heart surgery or catheter ablation.

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Atrial Flutter Electrophysiology Ablation Tachycardia 40

Frontiers in Cardiovascular Medicine

FEBRUARY 24, 2025

Head CT scans showed hypoattenuating areas indicative of cerebral infarction, chest CT suggested possible air accumulation in the left atrial region. ECG findings were consistent with atrial flutter, myocardial infarction, and incomplete right bundle branch block.

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Atrial Fibrillation Ablation Cardiogenic Shock Myocardial Infarction 52

HeartRhythm

JANUARY 6, 2025

A significant proportion of patients with isolated atrial flutter (AFL) will develop atrial fibrillation (AF) following cavotricuspid isthmus (CTI) ablation.

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Atrial Flutter Atrial Fibrillation Ablation Pulmonary 40

HeartRhythm

APRIL 30, 2024

Image-based patient-specific computational models have recently emerged as a tool to guide atypical atrial flutter (AAF) ablation. However, little is known about the sensitivity of these models to the selection of parameters.

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Atrial Flutter Ablation 40

HeartRhythm

APRIL 30, 2024

The competing risk of non-stroke mortality may limit the potential benefit of stroke prophylaxis therapy in patients with atrial fibrillation and/or atrial flutter (AF).

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Atrial Flutter Atrial Fibrillation Stroke Strokes 40

HeartRhythm

APRIL 30, 2024

Concerns about the safety of coronavirus disease (COVID-19) vaccines in patients with atrial fibrillation/atrial flutter (AF/AFL) have arisen due to reports of an association between thromboembolic events and COVID-19 vaccination.

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COVID-19 Atrial Flutter Atrial Fibrillation 40

HeartRhythm

APRIL 30, 2024

However, there is a need to deliver flexible lesions for atrial flutter (AFL) and non-PV ablations. Single-shot pulsed field ablation (PFA) catheters for pulmonary vein isolation are being studied. A 7Fr PFA catheter (PFLinear, EnChannel Medical) capable of delivering both focal and linear ablations has been developed.

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Atrial Flutter Ablation Pulmonary 40

HeartRhythm

APRIL 30, 2024

It is unclear how deep learning applied to VCG compares to physicians (EPs) for atrial flutter (AFL) detection. The representation of ECG vectors in X, Y, and Z axes in a vectorcardiogram (VCG) has shown diagnostic promise beyond single lead ECG (SL) analysis, with implications for novel ECG acquisition technologies.

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Atrial Flutter Electrocardiogram Technology 40

ECG Guru

DECEMBER 18, 2023

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1.

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Atrial Flutter Myocardial Infarction Tachycardia 75

HeartRhythm

APRIL 30, 2024

Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is often accompanied by atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT), which are difficult to control because beta-blockers and antiarrhythmic drugs can worsen heart failure (HF).

Atrial Flutter 40

Atrial Flutter Atrial Fibrillation Tachycardia Cardiomyopathy 40

Journal of Cardiovascular Electrophysiology

NOVEMBER 17, 2023

Abstract Introduction Cavo-tricuspid isthmus (CTI) dependent atrial flutter (AFL) is one of the most common atrial arrhythmias involving the right atrium (RA) for which radiofrequency catheter ablation has been widely used as a therapy of choice.

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Atrial Flutter Ablation Heart Transplant Tricuspid 40

Journal of Cardiovascular Electrophysiology

SEPTEMBER 26, 2024

The positive F wave in lead V1 changed during entrainment from the right atrial appendage (RAA) during typical atrial flutter (AFL). Abstract Introduction Typical atrial flutter (AFL) is a macroreentrant tachycardia in which intracardiac conduction rotates counterclockwise around the tricuspid annulus.

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Atrial Flutter Tachycardia Tricuspid Electrocardiogram 40

Dr. Smith's ECG Blog

AUGUST 23, 2017

It is atrial flutter with 2:1 conduction. There are clear flutter waves in lead II across the bottom. In V1, there are upright waves that appear to be P-waves but are not: they are atrial waves and it is typical for atrial flutter waves to be upright in V1, whereas sinus P-waves are biphasic in V1.

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Atrial Flutter Tachycardia Atrial Fibrillation Article 52

Dr. Smith's ECG Blog

JULY 5, 2024

A fully upright P-wave is typical atrial activity of atrial flutter as seen in V1. See these example cases of upright P-waves: Case Continued Thus, I was all but certain that this was atrial flutter.

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Atrial Flutter Tachycardia Atrial Fibrillation AFIB 113

Dr. Smith's ECG Blog

DECEMBER 27, 2014

If it is slow Atrial flutter with 1:1 conduction, it should slow the conduction and reveal the flutter waves. This is the exact rate one expects with slow atrial flutter and it is why slow atrial flutter can be so dangerous: it conducts 1:1, with fast ventricular rates. Rate 120, flutter rate 240.

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Atrial Flutter Tachycardia Chest Pain Ischemia 52

Dr. Smith's ECG Blog

SEPTEMBER 17, 2021

- PSVT (which includes AVNRT and orthodromic AV reciprocating tachycardia) [AVRT uses an accessory pathway, a "bypass tract" and thus is seen in WPW; about 30% of PSVT is orthodromic AVRT] - Atrial Flutter with 1:1 conduction. If you look closely at lead II across the bottom, it appears there are flutter waves. Which is it?

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Atrial Flutter Tachycardia Chest Pain Ischemia 52

Dr. Smith's ECG Blog

DECEMBER 26, 2020

There is the appearance of STE in inferior leads II, III, and aVF (with STD in aVR), but this is entirely due to flutter waves which are only seen in those leads. Also, the atrial flutter in this case is relatively slow like in many other cases we've shown. Atrial Flutter with Inferior STEMI? Is this inferor STEMI?

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Atrial Flutter Ischemia STEMI Tachycardia 52

ECG Guru

SEPTEMBER 23, 2024

In the first section of the ECG we see coarse fibrillation waves and QRS complexes with very different RR intervals, which is why this is atrial fibrillation. It is not atrial flutter because the fibrillation waves are of different size and polarity (depending on the lead) and the intervals between the atrial actions are irregular.

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Atrial Fibrillation Atrial Flutter 64

DAIC

DECEMBER 29, 2023

The trial will evaluate the outcomes of therapy provided with the FARAPULSE PFA System versus AADs, including device-or procedure-related adverse events, the rates of freedom from AF, atrial flutter, or atrial tachycardia, as well as AF burden – a measurement of the amount of AF an individual experiences.

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Atrial Fibrillation Ablation Atrial Flutter Blood Clot 115

The American Journal of Cardiology

JULY 31, 2024

Publication date: Available online 31 July 2024 Source: The American Journal of Cardiology Author(s): Andrey Ardashev, Rod Passman, Irina Zotova, Igor Efimov, Eric Rytkin, Gregory Trachiotis, Bradley P.

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Atrial Flutter 40

American College of Cardiology

MAY 6, 2024

Although atrial fibrillation/atrial flutter (AFib/AFL) are common manifestations of transthyretin amyloid cardiomyopathy (ATTR-CM), a post hoc analysis of the ATTR-ACT study, published April 30 in JACC: CardioOncology, found they do not predict all-cause mortality.

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AFIB Atrial Flutter Atrial Fibrillation Cardiomyopathy 54

ECG Guru

SEPTEMBER 13, 2023

Let's first consider the heart rate: with a heart rate of 194 beats/min, the heart rate is too low for atrial flutter (1:1) (except in patients who have been pre-treated with medication), and the rate would be unusually high for atrial flutter with 2:1 conduction. What arrhythmia is present?

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Atrial Flutter Atrial Fibrillation Tachycardia Heart Rhythm 52

ECG Cases

JULY 17, 2018

How can the Bix Rule help distinguish Atrial Flutter from SVT? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter?

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Atrial Flutter Atrial Fibrillation Tachycardia 52

HeartRhythm

OCTOBER 6, 2024

Sinoatrial node (SAN) activation and sinoatrial conduction pathways (SACPs) have been assessed in animals, but not humans.

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Atrial Flutter 40

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The rhythm differential for narrow, regular, and tachycardic is sinus rhythm, SVT (encompassing AVNRT, AVRT, atrial tach, etc), and atrial flutter (another supraventricular rhythm which is usually considered separately from SVTs). Therefore this patient is either in some form of SVT or atrial flutter. If so, why?

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Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

SEPTEMBER 18, 2024

To me, it was clearly atrial flutter with 1:1 conduction. The rate of 280 is just right for atrial flutter. The waves look like atrial flutter waves, NOT like a wide ventricular complex. Reverted to atrial fibrillation with RVR while in the hospital 3 times and needed cardioversion.

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Atrial Flutter Exercise AFIB Tachycardia 64

HeartRhythm

APRIL 30, 2024

Activation mapping of atrial arrhythmias often require intracardiac EGMs because of its better visibility and reliability. However, one of the pitfalls of an activation map is that it is dependent on the stability of the timing reference.

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Atrial Flutter Arrhythmia 40