What is the Relationship of Atrial Flutter and Fibrillation?
FRANZ X. ROITHINGER,
MICHAEL D. LESH,
FRANZ X. ROITHINGER
Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
Search for more papers by this authorCorresponding Author
MICHAEL D. LESH
Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
Address for reprints: Michael D. Lesh, M.D., Section of Cardiac Electrophysiology, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, 500 Parnassus Avenue, Room MU 428, Box 1354, San Francisco, CA 94143-1354. Fax: (415) 476-6260; e-mail: [email protected]Search for more papers by this authorFRANZ X. ROITHINGER,
MICHAEL D. LESH,
FRANZ X. ROITHINGER
Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
Search for more papers by this authorCorresponding Author
MICHAEL D. LESH
Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, San Francisco, California
Address for reprints: Michael D. Lesh, M.D., Section of Cardiac Electrophysiology, Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, 500 Parnassus Avenue, Room MU 428, Box 1354, San Francisco, CA 94143-1354. Fax: (415) 476-6260; e-mail: [email protected]Search for more papers by this authorDr. Roithinger is funded by a grant from the Max Kade Foundation Inc. Dr. Lesh is supported in part by a grant from the National Institute of Health (# 1 RO 1 HL 55227).
Abstract
Animal models and human studies of atrial activation mapping and entrainment have considerably enhanced our understanding of the anatomical substrate for atrial flutter and created the basis for a definite cure with radiofrequency catheter ablation. As atrial flutter has now become a curable arrhythmia, emphasis is shifting to understand the most common arrhythmia: atrial fibrillation. Furthermore, from clinical observation, it is apparent that there is a relationship between atrial fibrillation and atrial flutter in patients with atrial arrhythmias. Techniques that have informed our understanding of the anatomical basis of atrial flutter may also be useful in understanding the relationship between atrial fibrillation and flutter, including animal models, clinical endocardial mapping, and intracardiac anatomical imaging. Thus, atrial anatomy and its relationship to electrophysiological findings, and the role of partial or complete conduction barriers around which reentry can and cannot occur, may be of importance for atrial fibrillation as well. Ultimately, the relationship between atrial fibrillation and atrial flutter may inform our understanding of the mechanisms of atrial fibrillation itself, and help to develop new approaches to device, catheter-based, and pharmacological therapy for atrial fibrillation.
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