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The Mechanism of Flutter Interval Alternans
Author(s) -
WAXMAN MENASHE B.,
KIRSH JOEL A.,
CAMERON DOUGLAS A.,
WALD ROBERT W.
Publication year - 1990
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1990.tb05062.x
Subject(s) - flutter , atrial flutter , medicine , cardiology , cardiac cycle , systole , isovolumetric contraction , reentry , electrocardiography , atrial fibrillation , diastole , blood pressure , mechanics , physics , aerodynamics
The mechanism of atrial flutter alternans was investigated by observing the effects of ventricular systole on gutter intervals in a patient with atrioventricular dissociation. Interval measurements were made both from atrial electrograms recorded from an esophageal electrode, and from surface ECG recordings. Flutter cycle intervals that occurred during a well‐defined period subsequent to ventricular systole were consistently prolonged by up to 30 msec relative to the baseline flutter cycle interval. This prolongation was observed in two vastly different electrode configurations, implying that motion artifact was not predominantly responsible. We concluded that, by altering the characteristics of the flutter reentry circuit, transient increases in atrial volume and/or pressure arising during ventricular systole were responsible for the lengthening of the flutter cycle intervals.