Mechanism of spontaneous transition from typical atrial flutter to atrial fibrillation: Role of ectopic atrial fibrillation foci

Ming Hsiung Hsieh, T. A I Ching-, Chin Feng Tsai, Y. U. Wen-Chung, L. I N Wei-Shiang, Jin Long Huang, Y. U A N Ding, Mau Song Chang, Shih Ann Chen

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33 Citations (Scopus)

Abstract

Paroxysmal AF has been known to be initiated by ectopic beats, especially in the pulmonary veins (PVs), and radiofrequency catheter ablation could cure it. We considered that the spontaneous transition from typical atrial flutter to AF also could be initiated by ectopic beats. Twenty patients (18 men, mean age 66 ± 14 years) with episodes spontaneous transition from typical atrial flutter to AF were included in this study. They underwent detailed mapping of both atria. All the patients had spontaneous AF initiated by ectopic beats, and all of them had typical atrial flutter and spontaneous transition from typical atrial flutter (12 patients with counterclockwise atrial flutter and 8 patients with clockwise atrial flutter) to AF. The transition was initiated by ectopic beats from the PVs (17 foci, 85%), crista terminalis (2 foci, 10%), and superior vena cava (1 focus, 5%). After successful ablation of AF foci, typical atrial flutter was induced again, but no spontaneous transition was found after at least 10 minutes of observation. We concluded that paroxysmal AF and spontaneous transition from typical atrial flutter to AF were initiated by ectopic beats, and successful catheter ablation of the ectopic foci can eliminate paroxysmal AF and spontaneous transition from typical atrial flutter to AF.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume24
Issue number1
Publication statusPublished - 2001

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Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hsieh, M. H., Ching-, T. A. I., Tsai, C. F., Wen-Chung, Y. U., Wei-Shiang, L. I. N., Huang, J. L., Ding, Y. U. A. N., Chang, M. S., & Chen, S. A. (2001). Mechanism of spontaneous transition from typical atrial flutter to atrial fibrillation: Role of ectopic atrial fibrillation foci. PACE - Pacing and Clinical Electrophysiology, 24(1), 46-52.