1.A case of a fetal atrial flutter.
Chinese Journal of Cardiology 2015;43(8):744-745
2.Transesophageal Atrial Pacing in Atrial Flutter.
Tae Ho RHO ; Man Young LEE ; In Soo PARK ; Jong Jin KIM ; Ho Joong YOON ; Kie Bae SEUNG ; Jae Hyung KIM ; Kyu Bo CHOI ; Soon Jo HONG
Korean Circulation Journal 1995;25(1):29-35
Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.
Atrial Fibrillation
;
Atrial Flutter*
;
Female
;
Humans
;
Male
3.Management of Atrial Flutter.
International Journal of Arrhythmia 2016;17(4):214-219
Atrial flutter is a macro-reentrant atrial arrhythmia characterized by regular atrial rate and constant P-wave morphology. The atrial flutter is divided into typical and atypical types, according to whether reentrant circuit involves the cavotricuspid isthmus. This review summarizes the management of atrial flutter based on 2015 ACC/AHA/HRS guideline.
Arrhythmias, Cardiac
;
Atrial Flutter*
;
Catheter Ablation
4.A Long Journey to the Truth: Primary Cardiac Lymphoma with Various Arrhythmias from Ventricular Tachycardia to Atrial Flutter
Sunhwa KIM ; Yoo Ri KIM ; Young CHOI ; Sung Hwan KIM ; Yong Seog OH
Korean Circulation Journal 2020;50(4):374-378
No abstract available.
Arrhythmias, Cardiac
;
Atrial Flutter
;
Lymphoma
;
Tachycardia, Ventricular
7.Simple Method of Counterclockwise Isthmus Conduction Block by Comparing Double Potentials and Flutter Cycle Length.
Kyoung Suk RHEE ; Keun Sang KWON ; Sun Hwa LEE ; Kang Hyu LEE ; Sang Rok LEE ; Jei Keon CHAE ; Won Ho KIM ; Jae Ki KO ; Gi Byoung NAM ; Kee Joon CHOI ; You Ho KIM
Korean Circulation Journal 2009;39(12):525-531
BACKGROUND AND OBJECTIVES: Local wide split double potentials are used as a parameter to determine complete conduction block during cavotricuspid isthmus ablation in patients with isthmus dependent atrial flutter. However, delayed slow conduction in that region can sometimes be very difficult to differentiate from complete block. Flutter cycle length (FCL) can be used to confirm isthmus conduction block, because FCL is a measure of conduction time around the tricuspid annulus (TA). This study was designed to determine which degree of splitting of the local electrograms is adequate to confirm complete isthmus block, using FCL as a reference. SUBJECTS AND METHODS: Cavotricuspid isthmus (CTI) ablation was performed in fifty consecutive patients. The interval between the pacing stimulus on the lateral side of the CTI and the first component of the double potentials on the block line (SD1) corresponded to the counterclockwise conduction time. The interval between the pacing stimulus and second component (SD2) represented the clockwise conduction time to the contralateral side of the ablation line. SD1 and SD2 were measured before and after complete isthmus block. RESULTS: An SD1+SD2 reaching 90% of the FCL identified the counterclockwise isthmus conduction block with 94% sensitivity and 100% specificity. CONCLUSION: If the sum of SD1 and SD2 following isthmus ablation was close to the FCL, complete conduction block was predicted with high diagnostic accuracy and positive predictive value for at least counterclockwise conduction.
Atrial Flutter
;
Catheter Ablation
;
Humans
;
Sensitivity and Specificity
;
Syndactyly
8.Electrophysiologic Characteristics in the Process of Conversion from Atrial Fibrillation to Atrial Flutter.
Sung Hee SHIN ; Young Hoon KIM ; Hyun Soo LEE ; Gyo Seung HWANG ; Byung Soo KIM ; Hojun RHEE ; Jin Won KIM ; Do Sun LIM ; Hong Seog SEO ; Man Ho LEE ; Wan Joo SHIM ; Dong Joo OH ; Young Moo RO
Korean Circulation Journal 2000;30(1):72-81
BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF) has long been recognized as a random phenomenon. Recent studies, however, suggest that activation sequence during atrial fibrillation is not entirely disorganized and organized activations as the transitional rhythm exists in the process of conversion from atrial fibrillation to atrial flutter. The purpose of this study is to characterize the process and significance of transitional rhythm during conversion of atrial fibrillation to atrial flutter. MATERIALS AND METHODS: In 9 patients with paroxysmal atrial fibrillation, 13 episodes that atrial fibrillation spontaneously converted to atrial flutter during electrophysiological study were analyzed. To map the right atrium (RA), 10 bipolar Halo catheter was positioned in the lateral free wall of the RA and multielectrode catheters were positioned in the coronary sinus, high RA, and His bundle area, respectively. Calculation of cycle length (CL) was performed with digital caliper during atrial fibrillation and atrial flutter. Direction of activation sequences was compared between transitional rhythm and following atrial flutter. RESULTS: During conversion of atrial fibrillation to atrial flutter, characteristic findings were observed as follows. 1) There was a gradual increase in atrial fibrillation cycle length before transitional rhythm. 2) A pause appeared in atrial fibrillation immediately prior to transitional rhythm, and between transitional rhythm and following atrial flutter. 3) Direction of activation sequences of the transitional rhythm to atrial flutter was concordant in 9 episodes and discordant in 4 episodes. 4) Spontaneous termination of atrial flutter (n=3) was also preceded by organized rhythm showing different sequence of activations from those of atrial flutter. CONCLUSION: A stereotypical pattern of activation sequence exists in the process of conversion of atrial fibrillation to atrial flutter. The occurrence of transitional rhythm influences the activation sequence of atrial flutter. Spontaneous termination of atrial flutter also preceded by transiently changing pattern of activation.
Atrial Fibrillation*
;
Atrial Flutter*
;
Bundle of His
;
Catheters
;
Coronary Sinus
;
Heart Atria
;
Humans
9.The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?.
Ung KIM ; Young Jo KIM ; Sang Wook KANG ; In Wook SONG ; Jung Hwan JO ; Sang Hee LEE ; Geu Ru HONG ; Jong Seon PARK ; Dong Gu SHIN
Yeungnam University Journal of Medicine 2007;24(2):197-205
BACKGROUND: The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. MATERIALS AND METHODS: Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. RESULTS: The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54+/-14%, 56+/-13% in group 1 and 47+/-16%, 52+/-13% in group 2. The differences between each two groups are statistically insignificant (2.2+/-1.5 in group 1 vs 5.4+/-9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40+/-4 mm, 41+/-4 mm in group1 and 44+/-8 mm, 41+/-4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6+/-0.9mm in group 1 vs -3.8+/-7.4 mm in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 (32+/-10 mm3/m2, 35+/-10 mm3/m2 in group 1 and 32+/-10 mm3/m2, 29+/-8 mm3/m2 in group 2, p<0.05). CONCLUSION: The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.
Atrial Fibrillation*
;
Atrial Flutter*
;
Catheter Ablation*
;
Follow-Up Studies
;
Heart Atria
;
Heart Ventricles
;
Humans
;
Stroke Volume
10.Wide QRS tachycardia during treatment with class ic antiarrhythmic agents in a patient with atrial fibrillation: report of 2 cases.
Jae Kwang SHIM ; Dong il LEE ; Byung Il CHANG ; Hyun Ju SHIN ; Ki Hyun BYUN ; Young Woo KIM ; Jong Hyun KIM
Korean Journal of Medicine 2003;65(Suppl 3):S727-S732
Wide QRS tachycardia may represent a rare proarrhythmic effect of some antiarrhythmic agents. Class Ic antiarrhythmic agents produce rate- dependent ventricular conduction slowing due to use-dependent sodium channel blockade, causing QRS prolongation in cases with an increased heart rate. The authors describe two cases of atrial flutter with 1:1 atrioventricular conduction exhibiting a wide QRS tachycardia while on therapy using flecainide and propafenone, and the difficulty in interpreting the ECG.
Atrial Fibrillation*
;
Atrial Flutter
;
Electrocardiography
;
Flecainide
;
Heart Rate
;
Humans
;
Propafenone
;
Sodium Channels
;
Tachycardia*