Biatrial electrograms during coarse atrial fibrillation and flutter-fibrillation

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Arrhythmias

Background:

• Coarse atrial fibrillation and flutter-fibrillation are complex atrial arrhythmias.
• Understanding their underlying electrical mechanisms is crucial for diagnosis and management.
• Scalar electrocardiogram (ECG) findings can suggest specific atrial electrical behaviors.

Purpose of the Study:

• To characterize the atrial electrogram patterns in patients with coarse atrial fibrillation and flutter-fibrillation.
• To differentiate the electrophysiological features of these two conditions.
• To explore the relationship between scalar ECG findings and detailed atrial electrical activity.

Main Methods:

• Recording of right and left atrial electrograms in 57 patients.
• Analysis of electrograms from patients with coarse atrial fibrillation or flutter-fibrillation on scalar ECG.
• Correlation of electrogram findings with scalar ECG characteristics.

Main Results:

• Coarse atrial fibrillation typically presented as biatrial fibrillation with periodic slowing and regularity.
• Dissimilar interatrial or right intra-atrial rhythms were less common in coarse atrial fibrillation.
• Flutter-fibrillation was associated with rapid regular atrial tachysystole (flutter) and often involved dissimilar interatrial rhythms or fragmented flutter.

Conclusions:

• Coarse atrial fibrillation and flutter-fibrillation exhibit distinct atrial electrogram patterns.
• These arrhythmias may arise from diverse underlying atrial electrical phenomena.
• Electrophysiological recordings provide deeper insights beyond scalar ECG interpretation.