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Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1 Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2 It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3 The TR route offers better procedure comfort, shorter hospitalization […]

Atrial flutter: from ECG to electroanatomical 3D mapping

Claudio Pedrinazzi, Ornella Durin, Giosuè Mascioli, Antonio Curnis, Riccardo Raddino, Giuseppe Inama, Livio Dei Cas
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Published Online: Jul 26th 2018 Heart International 2006;2(3-4):161-70
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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

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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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