We hypothesized that phase relationships of atrial flutter waves among different ECG leads could be used to discriminate atrial flutter mechanisms and that vectorcardiography could be used to identify such phase relationships. Twenty-seven ECGs reflecting counterclockwise (CCW) isthmus-dependent (ID) flutter and eight ECGs reflecting clockwise (CW) ID flutter were reviewed. Vector analysis identified the following chronologic sequence in the ECGs of 24 of the 27 CCW ID flutter vector loops: iso-electric in all leads, trough in II, peak in VI, peak in II, and trough in VI. The CW ID flutter ECGs had the reverse sequence in II and VI. The phase relationships of Leads II and VI track the CCW and CW activation sequences of ID flutter, even for ECGs not satisfying the prevalent polarity and morphology criteria.
|Original language||English (US)|
|Number of pages||4|
|Journal||Computers in Cardiology|
|State||Published - Dec 1 2004|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine