Back to Search
Start Over
A New Electrocardiographic Algorithm to Differentiate Upper Loop Re-Entry From Reverse Typical Atrial Flutter
- Source :
-
Journal of the American College of Cardiology (JACC) . Aug2005, Vol. 46 Issue 3, p524-528. 5p. - Publication Year :
- 2005
-
Abstract
- Objectives: This study was performed to differentiate upper loop re-entry (ULR) from reverse typical atrial flutter (AFL). Background: Right atrial ULR and reverse typical AFL have different mechanisms and ablation strategies, but similar electrocardiographic characteristics. Methods: This study included 26 patients with reverse typical AFL and 20 patients with ULR. The noncontact mapping system (EnSite-3000, Endocardial Solutions, St. Paul, Minnesota) was used to confirm diagnosis and guide successful radiofrequency ablation. Flutter wave polarity and amplitude in the 12-lead surface electrocardiogram were determined by two independent electrophysiologists. Results: The flutter wave polarity in leads I and aVL was significantly different between the reverse typical AFL and ULR groups (p ≤ 0.001). Voltage measurement revealed significant differences between reverse typical AFL and ULR in leads I, II, aVR, aVF, V1, and V2 (p < 0.001). A new diagnostic algorithm based on negative or isoelectric/flat flutter wave polarity and amplitude ≤0.07 mV in lead I was useful for diagnosis of ULR, with an accuracy of 90% to 97%, a sensitivity of 82% to 100%, and a specificity of 95%. Conclusions: Polarity and voltage measurement of flutter wave in lead I can differentiate reverse typical AFL from ULR. [Copyright &y& Elsevier]
- Subjects :
- *ELECTROCARDIOGRAPHY
*ALGORITHMS
*ABLATION (Aerothermodynamics)
*RADIO frequency
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Volume :
- 46
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Cardiology (JACC)
- Publication Type :
- Academic Journal
- Accession number :
- 18162073
- Full Text :
- https://doi.org/10.1016/j.jacc.2005.04.049