Vol 18, No 4 (2011)
Interesting electrocardiograms
Published online: 2011-07-15
Typical atrial flutter with atypical flutter wave morphology due to abnormal interatrial conduction
Cardiol J 2011;18(4):450-453.
Abstract
We report a case of typical counterclockwise atrial flutter (AFL) with conduction block from
right to left atrium along the coronary sinus (CS) musculature, confirmed by discontinuous
CS activation sequence during pacing near the ostium and differential right atrial pacing.
AFL was associated with an atypical flutter wave morphology, due to the detour of the activation
wavefront from right to left atrium via alternate interatrial electrical connections, such as
Bachmann’s bundle, the interatrial septum, or both. (Cardiol J 2011; 18, 4: 450–453)
Keywords: atrial flutterflutter waveinteratrial connectiondiagnostic pacingcoronary sinus musculature
