Funding Sources: None.
Predictors of Unusual ECG Characteristics in Cavotricuspid Isthmus-Dependent Atrial Flutter Ablation
Article first published online: 23 MAY 2011
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 34, Issue 10, pages 1251–1257, October 2011
How to Cite
HOFFMAYER, K. S., YANG, Y., JOSEPH, S., MCCABE, J. M., BHAVE, P., HSU, J., NG, R. K., LEE, B. K., BADHWAR, N., LEE, R. J., TSENG, Z. H., OLGIN, J. E., NARAYAN, S. M., MARCUS, G. M. and SCHEINMAN, M. M. (2011), Predictors of Unusual ECG Characteristics in Cavotricuspid Isthmus-Dependent Atrial Flutter Ablation. Pacing and Clinical Electrophysiology, 34: 1251–1257. doi: 10.1111/j.1540-8159.2011.03137.x
- Issue published online: 13 OCT 2011
- Article first published online: 23 MAY 2011
- Received January 3, 2011; revised March 28, 2011; accepted March 28, 2011.
- cavotricuspid isthmus-dependent flutter;
- unusual 12-lead ECG pattern;
- ejection fraction
Background: An unusual 12-lead electrocardiographic pattern may be present in patients with cavotricuspid isthmus (CTI)-dependent flutter.
Objective: Using baseline patient characteristics and echocardiography, we sought to study predictors of unusual electrocardiogram (ECG) characteristics in patients with CTI-dependent atrial flutter.
Methods: This was a dual-center, retrospective cohort study of 147 patients undergoing electrophysiology study and ablation for CTI-dependent atrial flutter.
Results: Among this cohort, 23 patients (16%) had unusual 12-lead ECG characteristics. Using multivariate logistic regression, we found two clinical predictors for having an unusual ECG pattern. A clockwise (CW) pattern at time of electrophysiology study was the strongest predictor of an unusual ECG pattern (odds ratio 15.3, 95% confidence interval [CI] 4.0–59.4, P < 0.005). In addition, patients with decreased systolic function had a 3.5 greater odds (95% CI 1.1–11.5, P = 0.037) of having an unusual ECG pattern.
Conclusions: Our data demonstrate that among patients suffering from CTI-dependent atrial flutter who are referred for ablation, 16% will have unusual ECG patterns. Patients with CW atrial activation and left ventricle dysfunction have greater odds of manifesting unusual patterns by surface electrocardiogram. (PACE 2011; 34:1251–1257)