Advertisement

Moving Beyond ‘Fib/Flutter’

  • Tharian S. Cherian
    Affiliations
    Cardiovascular Division, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
    Search for articles by this author
  • Robert D. Schaller
    Affiliations
    Cardiovascular Division, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
    Search for articles by this author
  • David S. Frankel
    Correspondence
    Requests for reprints should be addressed to David S. Frankel, MD, Cardiovascular Division, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce St., 9 Founders Pavilion, Philadelphia, PA 19104.
    Affiliations
    Cardiovascular Division, Electrophysiology Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
    Search for articles by this author
Published:September 08, 2021DOI:https://doi.org/10.1016/j.amjmed.2021.07.043
      A man in his 70s with past medical history of hypertension and coronary artery disease presented to the Emergency Department with palpitations, fatigue, and dyspnea on exertion. On physical examination, he was alert and in mild distress. His heart rate was 97 beats per minute and blood pressure was 162/79 mm Hg. Cardiovascular examination was notable for irregularly irregular rhythm. The 12-lead electrocardiogram (ECG) is shown in the Figure, panel A.
      Figure
      Figure(A) Presenting 12-lead electrocardiogram. The electrocardiogram (ECG) shows chaotic atrial activity, irregular ventricular response and occasional premature ventricular complexes. (B) Twelve-lead ECG of typical atrial flutter. Multiple ECG leads demonstrate flutter waves of consistent morphology, amplitude, and cycle length.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hayashi T
        • Fukamizu S
        • Hojo R
        • et al.
        Prevalence and electrophysiological characteristics of typical atrial flutter in patients with atrial fibrillation and chronic obstructive pulmonary disease.
        Europace. 2013; 15: 1777-1783
        • Maskoun W
        • Pino MI
        • Ayoub K
        • et al.
        Incidence of atrial fibrillation after atrial flutter ablation.
        JACC Clin Electrophysiol. 2016; 2: 682-690
        • Roithinger FX
        • SippensGroenewegen A
        • Karch MR
        • Steiner PR
        • Ellis WS
        • Lesh MD
        Organized activation during atrial fibrillation in man: endocardial and electrocardiographic manifestations.
        J Cardiovasc Electrophysiol. 1998; 9: 451-461
        • Knight BP
        • Michaud GF
        • Strickberger SA
        • Morady F
        Electrocardiographic differentiation of atrial flutter from atrial fibrillation by physicians.
        J Electrocardiol. 1999; 32: 315-319
        • Bogun F
        • Anh D
        • Kalahasty G
        • et al.
        Misdiagnosis of atrial fibrillation and its clinical consequences.
        Am J Med. 2004; 117: 636-642