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.

Atrial Flutter 129

Atrial Flutter Blog Aortic Dysrhythmia 129

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

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.

Atrial Flutter 40

Atrial Flutter Atrial Fibrillation Pediatrics AFIB 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.

Atrial Flutter 52

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.

Atrial Flutter 40

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).

Atrial Flutter 40

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

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.

Atrial Flutter 40

Atrial Flutter Ablation Tricuspid Arrhythmia 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.

Atrial Flutter 40

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).

Atrial Flutter 40

Atrial Flutter Atrial Fibrillation Strokes Stroke 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.

COVID-19 40

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.

Atrial Flutter 40

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.

Atrial Flutter 40

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.

Atrial Flutter 75

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.

Atrial Flutter 40

Atrial Flutter Ablation Heart Transplant Tricuspid 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.

Atrial Flutter 52

Atrial Flutter Tachycardia Atrial Fibrillation Article 52

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.

Atrial Flutter 40

Atrial Flutter Tachycardia Tricuspid Electrocardiogram 40

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.

Atrial Fibrillation 72

Atrial Fibrillation Atrial Flutter 72

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.

Atrial Flutter 52

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?

Atrial Flutter 52

Atrial Flutter Ischemia STEMI Tachycardia 52

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.

AFIB 58

AFIB Atrial Flutter Atrial Fibrillation Cardiomyopathy 58

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.

Atrial Flutter 101

Atrial Flutter Tachycardia Atrial Fibrillation AFIB 101

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.

Atrial Fibrillation 115

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.

Atrial Flutter 40

Atrial Flutter 40

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?

Atrial Flutter 52

Atrial Flutter Atrial Fibrillation Heart Rhythm Tachycardia 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?

Atrial Flutter 52

Atrial Flutter Atrial Fibrillation 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.

Atrial Flutter 67

Atrial Flutter Exercise AFIB Tachycardia 67

Dr. Smith's ECG Blog

FEBRUARY 9, 2024

Written by Jesse McLaren A 65 year old with a history of atrial flutter, CABG and end-stage renal disease on dialysis presented with 3 days of fluctuating chest pain, which was ongoing at triage. What do you think? Do you need posterior leads?

Chest Pain 116

Chest Pain STEMI Atrial Flutter Ischemia 116

HeartRhythm

OCTOBER 6, 2024

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

Atrial Flutter 40

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?

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

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.

Atrial Flutter 40

Atrial Flutter Arrhythmia 40

Dr. Smith's ECG Blog

MAY 1, 2023

This narrows our differential for the rhythm down to sinus tachycardia, paroxysmal supraventricular tachycardia (PSVT, or SVT), and atrial flutter. The patient’s history is notable for paroxysmal atrial fibrillation, which raises clinical suspicion for atrial flutter, since these two entities frequently coexist on a spectrum.

Atrial Flutter 52

Atrial Flutter Tachycardia Arrhythmia Blog 52

Dr. Smith's ECG Blog

DECEMBER 16, 2018

Instead, the rate of 150, plus the history of AF, suggested atrial flutter. A close inspection of lead II showed P or flutter waves at a rate of about 300 bpm, also supporting atrial flutter. There appear to be flutter waves at a rate of 300. Flecainide encourages new atrial flutter.

Tachycardia 52

Tachycardia Atrial Flutter AFIB Atrial Fibrillation 52

HeartRhythm

APRIL 30, 2024

When mutiple atrial tachycardias coexist, ablation of an individual isthmus may lead to a seamless transition (without significant changes in surface ECG or coronary sinus activation) to a second rhythm. The isthmus block could go unnoticed leading to continued unnecessary ablations.

Atrial Flutter 40

Atrial Flutter Ablation Tachycardia 40