From the Third Department of Cardiology, Athens University School of Medicine, Athens, Greece.
Cardiol Rev. 2017 Nov/Dec;25(6):289-297. doi: 10.1097/CRD.0000000000000162.
Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI; typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location; however, additional entrainment and more sophisticated electroanatomical mapping techniques may be required to identify its mechanism, location, and target area for a successful ablation. Although atrial fibrillation and AFlu are 2 separate arrhythmias, they often coexist before and after drug and/or ablation therapies. Indeed, there appears to be a close interrelationship between these 2 arrhythmias, and one may "transform" into the other. These issues are discussed in this overview, and practical algorithms are proposed to guide AFlu localization and illustrate the AFlu and atrial fibrillation continuum.
心房颤动（AFlu）通常是一种快速（>240 bpm）且规则的右心房大折返性心动过速，折返环路的受限关键区域位于三尖瓣峡部（CTI；典型的 CTI 依赖性 AFlu）。然而，由于不同机制引起的各种右房和左房心动过速也可表现为 AFlu（非典型的非 CTI 依赖性 AFlu）。心电图可以提供其起源和位置的线索；然而，可能需要额外的拖带和更复杂的电生理标测技术来确定其机制、位置以及消融的目标区域，以获得成功。尽管心房颤动和 AFlu 是两种不同的心律失常，但它们在药物和/或消融治疗前后常常同时存在。事实上，这两种心律失常之间似乎存在密切的相互关系，一种可能“转变”为另一种。本文综述讨论了这些问题，并提出了实用的算法来指导 AFlu 定位，并说明 AFlu 和心房颤动的连续性。
