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The interrelationship between atrial fibrillation and atrial flutter.
1Department of Medicine, Case Western Reserve University, Cleveland, OH, USA. alw2@po.cwru.edu
Progress in Cardiovascular Diseases
|October 1, 2005
Summary
Atrial fibrillation often precedes atrial flutter by forming necessary circuit components. Rapid atrial flutter can also trigger atrial fibrillation through fibrillatory conduction, highlighting their close relationship.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation and atrial flutter share a known clinical interrelationship.
- Recent electrophysiological mapping studies have deepened the understanding of this connection.
Purpose of the Study:
- To elucidate the electrophysiological mechanisms underlying the relationship between atrial fibrillation and atrial flutter.
- To clarify how atrial fibrillation may lead to atrial flutter and vice versa.
Main Methods:
- Review of recent electrophysiological mapping studies.
- Analysis of experimental models and patient data.
Main Results:
- Atrial fibrillation typically precedes atrial flutter, during which a critical line of block between the venae cavae forms, enabling flutter circuit completion.
- The presence or absence of this line of block is a major determinant in the development of classical atrial flutter.
- A rapidly firing driver, such as a short-cycle-length reentrant circuit (fast atrial flutter), can induce atrial fibrillation via fibrillatory conduction.
Conclusions:
- Atrial fibrillation and atrial flutter are intricately linked through shared electrophysiological mechanisms.
- The formation of a line of block is crucial for atrial flutter development following atrial fibrillation.
- Rapid atrial flutter can act as a driver for atrial fibrillation, suggesting a spectrum of reentrant activity.