What is the pathophysiology of atypical atrial flutter (AFL)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Atypical atrial flutters are less extensively studied and electroanatomically characterized. Atypical atrial flutters may originate from the right atrium, as a result of surgical scars (ie, incisional reentry), or from the left atrium, specifically the pulmonary veins (ie, focal reentry) or mitral annulus (see the image below). Left atrial flutter is common and often problematic after incomplete left atrial linear ablation procedures (for atrial fibrillation). Thus, tricuspid isthmus dependency is not a prerequisite for atypical atrial flutter.

Electrocardiogram of atypical left atrial flutter. Electrocardiogram of atypical left atrial flutter.

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