On the basis of studies in experimental animals and on vector analysis of electrocardiograms in humans, Lewis and colleagues concluded that atrial flutter was the result of circus movement in the atria. 2 The mechanism of classical atrial flutter-the importance of block between the venae cavae Critical to the latter consideration is the increasing recognition that atrial flutter may be due to macroreentrant circuits which are different than that responsible for typical and reverse typical atrial flutter.
If it is critically short, it will create fibrillatory conduction and clinical atrial fibrillation if it is sufficiently long, it will result in 1:1 activation of the atria by the reentrant circuit, with resulting clinical atrial flutter. the cycle length of a stable atrial reentrant circuit which develops. We shall also develop the theme that another of the fundamental features that determine whether the atrial tachyarrhythmia becomes atrial flutter or atrial fibrillation often will be the atrial flutter cycle length, i.e. We shall develop the theme that one of the fundamental features that determines whether an atrial tachyarrhythmia becomes sustained atrial flutter or atrial fibrillation is the development of the line of block between the venae cavae. Critical to the development and maintenance of this reentrant circuit are the lateral boundaries, one being fixed (anatomic), the tricuspid valve annulus, and the other almost always being functional, a line of block between the venae cavae. Are these clinical associations mere coincidences, or do they reflect an important underlying similar pathophysiology and even similar mechanism(s)? Data derived largely from a series of unconnected studies in animal models and patients seemingly point to a clear interrelationship between the two, suggesting, if not indicating, that they are two sides of a coin.Ĭlassical atrial flutter, now called typical and reverse typical atrial flutter, is well recognized to be due to a macro-reentrant mechanism, in which the reentrant wave front travels up the inter-atrial septum and down the right atrial free wall or vice versa, respectively. And some antiarrhythmic agents, notably class IC drugs, IA drugs and amiodarone, used to suppress atrial fibrillation not uncommonly ‘convert’ recurrences of atrial tachyarrhythmia to atrial flutter. Both are very common as a temporary atrial tachyarrhythmia shortly after open heart surgery, and often in the same patient.
Patients who primarily manifest atrial flutter commonly also experience atrial fibrillation and vice versa. There has been a long recognized clinical interrelationship between atrial flutter and atrial fibrillation. We also are able to utilize the most advanced mapping systems.Arrhythmia (mechanisms), Conduction (block), Impulse formation, Mapping, Supraventricular arrhythmia We are one of only a handful of centers in the United States that provide a complete suite of approaches to AFib, including hybrid procedures with epicardial robotic surgery in conjunction with endocardial ablation. Current research seeks to understand the mechanisms of atrial fibrillation, which appear to come from multiple areas at the same time.Īt the University of Chicago Medicine, our team uses special catheters that allow them to know how much force is being applied onto the tissue, which has been shown to improve the success rate for the procedure.
We start with the initial set of treatments and then we get more aggressive as the pest problem declares itself to be more and more stubborn. We come in and we do a treatment and we can control the cases but frequently it requires multiple treatments. We give patients the analogy that atrial fibrillation is like a pest problem in your home. Similar to atrial flutter, treatment options for AFib include anticoagulation (blood thinners) and controlling the arrhythmia with medication or catheter ablation therapy.Īblation is also effective in 60% to 70% of AFib patients.