title: Atrial flutter: more than just one of a kind.
abstract: Since its first description about one century ago, our understanding of atrial flutter (AFL) circuits has considerably evolved. One AFL circuit can have variable electrocardiographic (ECG) manifestations depending on the presence of pre-existing atrial lesions, or impaired atrial substrate. Conversely, different (right sided or even left sided) atrial circuits including different mechanisms (macroreentrant, microreentrant, or focal) can present with a very similar surface ECG manifestation. The development of efficient high-resolution electroanatomical mapping systems has improved our knowledge about AFL mechanisms, as well as facilitated their curative treatment with radiofrequency catheter ablation. This article will review ECG features for typical and atypical flutters, and emphasize the limitations for circuit location from the surface ECG.
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco sithi.bun@gmail.com.
authors.forename: Sok-Sithikun
authors.initials: SS
authors.lastname: Bun
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco.
authors.forename: Decebal Gabriel
authors.initials: DG
authors.lastname: Latcu
authors.affiliation: Cardiology Division, Section of Electrophysiology, University of Pennsylvania, USA.
authors.forename: Francis
authors.initials: F
authors.lastname: Marchlinski
authors.affiliation: Department of Cardiology, Princess Grace Hospital, Pasteur Avenue, Monaco (Principality), Monaco Cardiology Division, Section of Electrophysiology, University of Pennsylvania, USA.
authors.forename: Nadir
authors.initials: N
authors.lastname: Saoudi
mesh_terms: D001282:Atrial Flutter / Q000145:classification* / Q000503:physiopathology / Q000628:therapy; D016279:Atrial Function, Left / Q000502:physiology; D017115:Catheter Ablation / Q000379:methods; D002921:Cicatrix / Q000503:physiopathology / Q000628:therapy; D054326:Coronary Sinus / Q000502:physiology; D004562:Electrocardiography; D006801:Humans; D013610:Tachycardia / Q000503:physiopathology / Q000628:therapy
keywords: Atypical atrial flutter; Cavotricuspid isthmus dependent; ECG; Typical atrial flutter