Prediction of the atrial flutter circuit location from the surface electrocardiogram

Abstract

Identification of atypical atrial flutter (AFL) (non-cavo-tricuspid isthmus-dependent) prior to the electrophysiology laboratory is potentially useful because it allows appropriate procedural planning and enables discussion of the likely success rates and risks of the procedure with the patient. Typical counterclockwise AFL has a stereotypic appearance, the electrocardiogram (ECG) is predictive of the diagnosis in the majority of cases, and ablation procedures are associated with a high degree of safety and success. Atypical right atrial and left AFLs have a highly variable flutter wave morphology and may appear atypical, resemble typical flutter or appear to be focal in origin. Targeting th..