Katov Lyuboslav, Reiländer Sonja, Schlarb Alyssa, Diofano Federica, Aktolga Deniz, Teumer Yannick, Bothner Carlo, Rottbauer Wolfgang, Weinmann-Emhardt Karolina
Department of Cardiology, Ulm University Heart Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
Diagnostics (Basel). 2025 Apr 25;15(9):1095. doi: 10.3390/diagnostics15091095.
: Atrial flutter (AFL) is a macro-reentrant tachycardia classified as cavotricuspid isthmus (CTI)-dependent or non-CTI-dependent based on its reliance on the CTI for conduction. CTI dependence can present as type I ECG (sawtooth flutter waves in inferior leads and positive P-waves in V1) or type II ECG (absence of these characteristics). This study aimed to identify clinical and electrophysiological parameters to improve CTI dependence prediction in AFL. : Patients at the Ulm University Heart Center between 2010 and 2019 with AFL undergoing electrophysiological studies and ablation were enrolled. Clinical and electrophysiological parameters such as age, gender, prior comorbidities, interventions, and medication use were analyzed. : The study included 383 patients, with 70% presenting with type I ECG AFL. CTI dependence was observed in 242 (90.3%) type I ECG patients and 52 (45.2%) type II ECG patients. CTI-dependent AFL patients were younger and had fewer comorbidities. Predictors for CTI dependence in type I ECG included male gender ( = 0.006), absence of beta-blocker use ( = 0.031), no prior atrial fibrillation ( = 0.035), and no prior pulmonary vein isolation ( < 0.001). In type II ECG, predictors for CTI dependence included younger age ( = 0.016), male gender ( = 0.007), absence of arterial hypertension ( = 0.036), and longer atrial cycle length ( < 0.001). : Identifying clinical and electrophysiological parameters enhances the ability to predict CTI dependence in AFL, offering valuable insights for tailored diagnostic and therapeutic approaches. Coupling these parameters with ECG findings holds promise for refining prediction accuracy and optimizing patient care.
心房扑动（AFL）是一种大折返性心动过速，根据其传导对三尖瓣峡部（CTI）的依赖程度可分为CTI依赖性或非CTI依赖性。CTI依赖性可表现为I型心电图（下壁导联呈锯齿状扑动波，V1导联P波直立）或II型心电图（无这些特征）。本研究旨在确定临床和电生理参数，以改善AFL中CTI依赖性的预测。：纳入2010年至2019年间在乌尔姆大学心脏中心接受电生理研究和消融的AFL患者。分析了年龄、性别、既往合并症、干预措施和药物使用等临床和电生理参数。：该研究纳入了383例患者，其中70%表现为I型心电图AFL。在242例（90.3%）I型心电图患者和52例（45.2%）II型心电图患者中观察到CTI依赖性。CTI依赖性AFL患者更年轻，合并症更少。I型心电图中CTI依赖性的预测因素包括男性（P = 0.006）、未使用β受体阻滞剂（P = 0.031）、无既往心房颤动（P = 0.035）和无既往肺静脉隔离术（P < 0.001）。在II型心电图中，CTI依赖性的预测因素包括年龄较小（P = 0.016）、男性（P = 0.007）、无动脉高血压（P = 0.036）和较长的心房周期长度（P < 0.001）。：识别临床和电生理参数可增强预测AFL中CTI依赖性的能力，为量身定制的诊断和治疗方法提供有价值的见解。将这些参数与心电图结果相结合有望提高预测准确性并优化患者护理。
