Milliez Paul
Service de cardiologie, hôpital Lariboisière, 75475 Paris Cedex 10.
Rev Prat. 2004 Feb 15;54(3):266-72.
Definitions, classification, surface electrocardiographic characterisitics, risk for stroke and treatments. Atrial flutters are macro-reentrant circuits originated from both right and left atria. They have been classified in typical and atypical based on their cavo-tricuspid isthmus-dependence. Typical atrial flutter comprises counterclockwise and clockwise isthmus-dependent atrial flutter located within the right atrium. Atypical atrial flutters are composed by non-isthmus-dependent right atrial flutter and left atrial flutter. Typical atrial flutter represents at least 90% of all flutters, and has usually a counterclockwise pattern. Ablation is a potential definitive therapy for atrial flutter. However, successful procedures as well as complications rates are different depending of the location of the circuit. There are now evidences for risk of stroke related to atrial flutter, although epidemiological studies have not been conducted yet. Therefore, prevention of such complications using anti-thrombotic should be performed as done for atrial fibrillation.
定义、分类、体表心电图特征、中风风险及治疗方法。心房扑动是起源于右心房和左心房的大折返环路。根据其对腔静脉-三尖瓣峡部的依赖性,可分为典型和非典型心房扑动。典型心房扑动包括位于右心房内的逆时针和顺时针峡部依赖性心房扑动。非典型心房扑动由非峡部依赖性右心房扑动和左心房扑动组成。典型心房扑动占所有扑动的至少90%,通常呈逆时针模式。消融是心房扑动的一种潜在确定性治疗方法。然而,成功的手术以及并发症发生率因环路位置而异。目前有证据表明心房扑动与中风风险相关,尽管尚未进行流行病学研究。因此,应像治疗心房颤动一样使用抗栓药物预防此类并发症。