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Electrophysiological Mechanisms of Atrial Flutter

Tai, Ching- Tai and Chen, Shin-Ann (2006) Electrophysiological Mechanisms of Atrial Flutter. [Journal (Paginated)]

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Abstract

Atrial flutter (AFL) is a common arrhythmia in clinical practice. Several experimental models such as tricuspid regurgitation model, tricuspid ring model, sterile pericarditis model and atrial crush injury model have provided important information about reentrant circuit and can test the effect of antiarrhythmic drugs. Human atrial flutter has typical and atypical forms. Typical atrial flutter rotates around tricuspid annulus and uses the crista terminalis and sometimes sinus venosa as the boundary. The IVC-tricuspid isthmus is a slow conduction zone and the target of radiofrequency ablation. Atypical atrial flutter may arise from the right or left atrium. Right atrial flutter includes upper loop reentry, free wall reentry and figure of eight reentry. Left atrial flutter includes mitral annular atrial flutter, pulmonary vein-related atrial flutter and left septal atrial flutter. Radiofrequency ablation of the isthmus between the boundaries can eliminate these arrhythmias.

Item Type:Journal (Paginated)
Keywords:Antiarrhythmic drugs; Atrial flutter
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4804
Deposited By: Indian Pacing and Electrophysiology, Journal
Deposited On:01 Apr 2006
Last Modified:11 Mar 2011 08:56

References in Article

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1. Jolly WA, Ritchie. Auricular flutter and fibrillation. Heart 1910;2:177.

2. Lewis T, Drury AN, Iliesc TT. A demonstration of circus movement in clinical flutter of the auricles. Heart 1921;8:341.

3. Rosenblueth A, Garcia-Ramos J. Studies on flutter and fibrillation. II:The influence of artificial obstacles on experimental auricular flutter. Am Heart J 1947;33:677-684.

4. Scerrf D. Studies on auricular tachycardia caused by aconitine administration. Proc Soc Exp Biol Med 1947;64:233.

5. Boyden PA, Hoffman BF. The effects on atrial electrophysiology and structure of surgically induced right atrial enlargement in dogs. Circ Res 1981;49:1319.

6. Frame LH, Page RL, Hoffman BF. Atrial reentry around an anatomic barrier with a partially refractory excitable gap: A canine model of atrial flutter. Circ Res 1986;58:495-511.

7. Page P, Plumb VJ, Okumura K, Waldo AL. A new model of atrial flutter. J Am Coll Cardiol 1986;8:872-879.

8. Feld GK, Shahandeh-Rad F. Activation patterns in experimental canine atrial flutter produced by right atrial crush-injury. J Am Coll Cardiol 1992;20:441-451.

9. Olshansky B, Okumura K, Hess PG, et al. Demonstration of an area of slow conduction in human atrial flutter. J Am Coll Cardiol 1990;16:1639-1648.

10. Tai CT, Chen SA, Chiang CE, et al. Characterization of low right atrial isthmus as the slow conduction zone and pharmacological target in typical atrial flutter. Circulation 1997;96:2601-2611.

11. Feld GK, Mollerus M, Birgersdotter-Green U, et al. Conduction velocity in the tricuspid valve-inferior vena cava isthmus is slower in patients with type I atrial flutter compared to those without a history of atrial flutter. J Cardiovasc Electrophysiol 1997;8:1338-1348.

12. Spach MS, Dolber PC, Heidlage JF. Influence of the passive anisotropic properties on directional differences in propagation following modification of the sodium conductance in human atrial muscle: A model of reentry based on anisotropic discontinuous propagation. Circ Res 1988;62:811-832.

13. Spach MS, Dolber PC. Relating extracellular potentials and their derivatives to anisotropic propagation at a microscopic level in human cardiac muscle: Evidence for electrical uncoupling of side-to-side fiber connections with increasing age. Circ Res 1986;58:356-371.

14. Cabrera JA, Sanchez-Quintana S, Ho SY, et al. The architecture of the atrial musculature between the orifice of the inferior cava vein and the tricuspid valve: The anatomy of the isthmus. J Cardiovasc Electrophysiol 1998;9:1186-1195.

15. Boineau JP, Schuessller RB, Mooney CR, et al. Natural and evoked atrial flutter due to circus movement in dogs. Am J Cardiol 1980;45:1167-1181.

16. Kalman JM, Olgin JE, Saxon LA, et al. Activation and entrainment mapping defines the tricuspid annulus as the anterior barrier in typical atrial flutter. Circulation 1996;94:398-406.

17. Olgin JE, Kalman JM, Fitzpatrick AP, et al. Role of right atrial endocardial structures as barriers to conduction during human type I atrial flutter: Activation and entrainment mapping guided by intracardiac echocardiography. Circulation 1995;92:1839-1848.

18. Tai CT, Chen SA, Chen YJ, et al. Conduction properties of the crista terminalis in patients with typical atrial flutter: Basis for a line of block in the reentrant circuit. J Cardiovasc Electrophysiol 1998;9:811-819.

19. Arenal A, Almendral J, Alday J, et al. Rate-dependent conduction block of the crista terminalis in patients with typical atrial flutter: Influence on evaluation of cavotricuspid isthmus conduction block. Circulation 1999;99:2771-2778.

20. Tada H, Oral H, Sticherling C et al. Double potentials along the ablation line as a guide to radiofrequency ablation of typical atrial flutter. Journal of the American College of Cardiology 2001 September 1;38(3):750-5.

21. Tai CT, Huang JL, Lee PC, Ding YA, Chang MS, Chen SA. High-resolution mapping around the crista terminalis during typical atrial flutter: new insights into mechanisms. J Cardiovasc Electrophysiol 2004;15:406-414.

22. Bella PD, Marenzi G, Tondo C, et al. Usefulness of excitable gap and pattern of resetting in atrial flutter for determining reentry circuit location. Am J Cardiol 1991;68:492-497.

23. Callans DJ, Schwartzman D, Gottlieb CD, et al. Characterization of the excitable gap in human type I atrial flutter. J Am Coll Cardiol 1997;30:1793-1801.

24. Tai CT, M.D., Lin YJ,M.D., Chen SA, M.D. A New Approach to the Differential Diagnosis of Right and Left Atrial Flutter (abstract). Heart Rhythm 2006.

25. Tai CT, Huang JL, Lin YK, et al. Noncontact three-dimensional mapping and ablation of upper loop reentry originating in the right atrium. J Am Coll Cardiol 2002;40:746-753.

26. Tai CT, Liu TY, Lee PC, Lin YJ, Chang MS, Chen SA. Noncontact mapping to guide Radiofrequency ablation of atypical right atrial flutter. J Am Coll Cardiol 2004;44:1080-1086.

27. Jais P, Hocini M, Hsu LF, Sanders P, Scavee C, Weerasooriya R, Macle L, Raybaud F, Garrigue S, Shah DC, Le Metayer P, Clementy J, Haissaguerre M. Technique and results of linear ablation at the mitral isthmus. Circulation 2004;110:2996-3002.

28. Jais P, Shah DC, Haissaguerre M, et al. Mapping and ablation of left atrial flutter. Circulation 2000;101:2928-2934.

29. Marrouche NF, Natale A, Wazni OM, et al. Left septal atrial flutter:electrophysiology, anatomy, and result of ablation. Circulation 2004;109:2440-2447.

30. Tai CT, Lin YK, Chen SA. Atypical atrial flutter involving the isthmus between the right pulmonary veins and fossa ovalis. PACE 2001;24:384-387.

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