title: Predictors of unusual ECG characteristics in cavotricuspid isthmus-dependent atrial flutter ablation.
abstract: BACKGROUND
  An unusual 12-lead electrocardiographic pattern may be present in patients with cavotricuspid isthmus (CTI)-dependent flutter.
  
  
  OBJECTIVE
  Using baseline patient characteristics and echocardiography, we sought to study predictors of unusual electrocardiogram (ECG) characteristics in patients with CTI-dependent atrial flutter.
  
  
  METHODS
  This was a dual-center, retrospective cohort study of 147 patients undergoing electrophysiology study and ablation for CTI-dependent atrial flutter.
  
  
  RESULTS
  Among this cohort, 23 patients (16%) had unusual 12-lead ECG characteristics. Using multivariate logistic regression, we found two clinical predictors for having an unusual ECG pattern. A clockwise (CW) pattern at time of electrophysiology study was the strongest predictor of an unusual ECG pattern (odds ratio 15.3, 95% confidence interval [CI] 4.0-59.4, P < 0.005). In addition, patients with decreased systolic function had a 3.5 greater odds (95% CI 1.1-11.5, P = 0.037) of having an unusual ECG pattern.
  
  
  CONCLUSIONS
  Our data demonstrate that among patients suffering from CTI-dependent atrial flutter who are referred for ablation, 16% will have unusual ECG patterns. Patients with CW atrial activation and left ventricle dysfunction have greater odds of manifesting unusual patterns by surface electrocardiogram.
authors: San Francisco, California San Diego, CA 94143–1354, USA.
authors: Kurt S
authors: KS
authors: Hoffmayer
authors: Yanfei
authors: Y
authors: Yang
authors: Stephen
authors: S
authors: Joseph
authors: James M
authors: JM
authors: McCabe
authors: Prashant
authors: P
authors: Bhave
authors: Jonathan
authors: J
authors: Hsu
authors: Ramford K
authors: RK
authors: Ng
authors: Byron K
authors: BK
authors: Lee
authors: Nitish
authors: N
authors: Badhwar
authors: Randall J
authors: RJ
authors: Lee
authors: Zian H
authors: ZH
authors: Tseng
authors: Jeffrey E
authors: JE
authors: Olgin
authors: Sanjiv M
authors: SM
authors: Narayan
authors: Gregory M
authors: GM
authors: Marcus
authors: Melvin M
authors: MM
authors: Scheinman
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