Circulation, Vol 57, 213-216, Copyright © 1978 by American Heart Association
CV Leier, JA Meacham and SF Schaal
Electrophysiological studies were performed during sinus rhythm on 21
patients who had demonstrated the spontaneous occurrence of sustained
atrial flutter. The purpose was to determine if atrial conduction disease
is a prediposing factor for the development of atrial flutter. Patients
with atrial enlargement were excluded from the series. The control group
consisted of 11 age-matched patients with normal electrocardiograms and
electrophysiology studies. The flutter group showed prolongation of the
mean right intra-atrial conduction time at 50 msec (control of 37 msec, P
less than 0.05), the mean interatrial conduction time at 92 msec (control
of 44 msec, P less than 0.001) and the mean P wave duration at 132 msec
(control of 112 msec, P less than 0.01). The flutter group also
demonstrated a higher incidence of sinus node dysfunction and ventricular
conduction disease compared to the control group. These data indicate that
patients who develop atrial flutter have atrial conduction disease. Atrial
conduction disease appears to be 1) a major prediposing factor for the
development of atrial flutter and 2) a part of the fibro-degenerative
conduction disease spectrum.
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Prolonged atrial conduction. A major predisposing factor for the development of atrial flutter
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