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See Latest ArticlesECG manifestations of left atrial flutter
Current Opinion in Cardiology, 01/09/09
Shah D et al. – Accurate activation mapping data of the full spectrum of left atrial reentry will facilitate development of clinically useful ECG algorithms.
Methods- Review of studies of the pathophysiology of arrhythmias originating from the left atrium
- Nonreentrant arrhythmias originating from the left atrium are characterized by specific ECG features of the P wave, primarily a positive or dominantly positive deflection in V1
- Bystander activation of the right atrium generates a dominantly positive deflection in V1 even during left atrial reentry
- Part of the reentry circuit may generate feeble electrical forces (eg, thin strand of myocardium) instead of continuous electrical activity on surface ECG due to continuous reentrant activation
- Discrete P waves separated by a 12-lead synchronous isoelectric interval may be produced
- P wave morphology can be used to infer the exit location from this slow-conducting isthmus and facilitate ablation
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