Atrial flutter: from ECG to electroanatomical 3D mapping
Abstract
Overview
Atrial flutter is a common arrhythmia that may cause significant symptoms, including
palpitations, dyspnea, chest pain and even syncope. Frequently it’s possible to diagnose
atrial flutter with a 12-lead surface ECG, looking for distinctive waves in leads II, III, aVF, aVL,
V1,V2. Puech and Waldo developed the first classification of atrial flutter in the 1970s. These authors
divided the arrhythmia into type I and type II. Therefore, in 2001 the European Society of
Cardiology and the North American Society of Pacing and Electrophysiology developed a new
classification of atrial flutter, based not only on the ECG, but also on the electrophysiological
mechanism. New developments in endocardial mapping, including the electroanatomical 3D
mapping system, have greatly expanded our understanding of the mechanism of arrhythmias.
More recently, Scheinman et al, provided an updated classification and nomenclature. The terms
like common, uncommon, typical, reverse typical or atypical flutter are abandoned because they
may generate confusion. The authors worked out a new terminology, which differentiates atrial flutter
only on the basis of electrophysiological mechanism. (Heart International 2006; 3-4: 161-70)
Keywords
Atrial flutter, Catheter ablation, ECG, Electroanatomical mapping
Article Information
Correspondence
Dr. Giuseppe Inama, Department of Cardiology, Ospedale Maggiore, Largo U. Dossena, 2, 26013 Crema – Italy, g.inama@hcrema.it
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