What Is the Relationship between Atrial Fibrillation and Flutter in Man?

  • M. D. Lesh
  • F. X. Roithinger
  • M. R. Karch
  • P. R. Steiner
  • A. SippensGroenewegen


In typical human counterclockwise or clockwise atrial flutter, the barriers of the right atrial reentrant circuit are reasonably well established, and curative ablation with a high rate of success is available for this arrhythmia [1–7]. Atrial fibrillation has long been described as a disorganized or random phenomenon [8]. Recent studies, however, found evidence that the activation during atrial fibrillation is not entirely random [9], suggesting similarities among these common arrhythmias. In an animal model, the conversion of atrial fibrillation into atrial flutter and back has been shown to occur spontaneously [10]. In humans, however, the conversion of one arrhythmia into the other has not been extensively analyzed, although recent studies found evidence that especially atrial fibrillation may spontaneously convert into atrial flutter [11, 12]. Thus, in the present article, we will review the role of atrial anatomy for the relationship between atrial fibrillation and atrial flutter and its consequences for diagnosis and treatment.


Atrial Fibrillation Atrial Flutter Radiofrequency Catheter Ablation Tricuspid Annulus Atrial Fibrilla 
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Copyright information

© Springer-Verlag Italia 1998

Authors and Affiliations

  • M. D. Lesh
    • 1
  • F. X. Roithinger
    • 1
  • M. R. Karch
    • 1
  • P. R. Steiner
    • 1
  • A. SippensGroenewegen
    • 1
  1. 1.Section of Cardiac Electrophysiology, Department of Medicine and Cardio-Vascular Research InstituteUniversity of California at San FranciscoUSA

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