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Related Experiment Videos

Inter-relationships between atrial flutter and atrial fibrillation.

Albert L Waldo1

  • 1Department of Medicine, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio 44106-50388, USA. alw2@po.cwru.edu

Pacing and Clinical Electrophysiology : PACE
|August 14, 2003
PubMed
Summary

Atrial fibrillation often precedes atrial flutter by forming critical block lines. Conversely, rapid atrial flutter can drive atrial fibrillation through short cycle length reentrant circuits.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Atrial flutter and atrial fibrillation share a known clinical relationship.
  • Technological advancements in electrophysiological studies, particularly mapping, have enhanced understanding of this interrelationship.

Purpose of the Study:

  • To elucidate the mechanisms underlying the relationship between atrial flutter and atrial fibrillation.
  • To clarify how atrial fibrillation may lead to atrial flutter and vice versa.

Main Methods:

  • Review of electrophysiological studies, focusing on mapping techniques.
  • Analysis of the formation and role of reentrant circuits and block lines in atrial arrhythmias.

Main Results:

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  • Atrial fibrillation frequently precedes atrial flutter, during which functional block lines between the vena cavae are formed, essential for flutter circuit initiation.
  • The presence, absence, or shortening of this intercaval block line dictates the development or cessation of classical atrial flutter.
  • A rapid atrial flutter, characterized by a short cycle length reentrant circuit, can act as a driver for atrial fibrillation by inducing fibrillatory conduction.

    • Conclusions:

    • The formation of an intercaval line of block is a key determinant in the transition between atrial fibrillation and atrial flutter.
    • Rapid atrial flutter represents a significant mechanism contributing to the initiation and maintenance of atrial fibrillation.