Development and validation of diagnostic criteria for atrial flutter on the surface electrocardiogram.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
Kenneth M WeinbergJeffrey J Goldberger

Abstract

There are no universally accepted ECG diagnostic criteria for atrial flutter (AFL), making its differentiation from "coarse" atrial fibrillation (AF) difficult. To develop diagnostic criteria for AFL, we examined two sets of ECGs. Set 1 consisted of 100 ECGs (50 AF, AFL) with diagnoses confirmed by intracardiac recordings. Criteria evaluated were presence of F waves in the frontal plane leads, F waves in V(1), sawtooth F waves, rate, and regularity of ventricular response. Set 2 included 200 ECGs taken from the hospital database each of which had already been interpreted by a cardiologist as either AF (n = 100) or AFL (n = 100). Set 2 was blindly read by electrophysiologists whose consensus-diagnoses were compared to the diagnoses made by using the best criteria identified from the Set 1 data. The criteria of frontal plane F waves, regular or partially regular ventricular response, and their combination had sensitivities of 92%, 98%, and 90% and specificities of 100%, 78%, and 100% in Set 1 for the diagnosis of AFL. In Set 2, concordance of electrophysiologist and cardiologist diagnoses was only 84%. The criteria of frontal plane Fwaves, regular or partially regular ventricular response, and their combination resulted in concor...Continue Reading

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Citations

Jul 4, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gaetano BarbatoGiuseppe Di Pasquale
Jun 5, 2010·Journal of Cardiovascular Electrophysiology·David E KrummenSanjiv M Narayan
Feb 12, 2010·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Shlomo Stern
Nov 19, 2013·Journal of Cardiovascular Electrophysiology·Jason D RobertsGregory M Marcus
Feb 8, 2011·The American Journal of Medicine·Sanjoy Bhattacharya, Norman C Wang
Nov 22, 2016·Pacing and Clinical Electrophysiology : PACE·Yasser RodriguezNorman C Wang

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