Criteria for the Electrocardiographic Diagnosis of Atrial Flutter Improve Diagnostic Accuracy

Kenneth M. Weinberg, Pablo Denes, Alan H. Kadish, Jeffrey J. Goldberger

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: We previously developed and validated diagnostic criteria for the differentiation of atrial flutter from atrial fibrillation. In this study we examine if the criteria (F waves in the frontal plane and a partially or completely regular ventricular response) can improve the diagnostic accuracy of internists. Methods: Two groups of 10 internists (1 group given the criteria and 1 not) read a set of electrocardiograms (ECGs) selected from the hospital database with cardiologist-confirmed diagnoses of atrial fibrillation, atrial flutter, or "atrial fibrillation-flutter" (100 each). The final diagnoses of all ECGs were provided by a consensus of electrophysiologists. The criteria also were used to establish the criteria-based diagnoses. Results: Of the 298 ECGs analyzed, the electrophysiologist diagnosis was atrial fibrillation in 71% and atrial flutter in 29%. The concordance of the internists' diagnoses with the electrophysiologist consensus diagnoses was 66 ± 12% for those not given the criteria and 81 ± 4% (P <.01) for those given the criteria. The concordance of the internists' diagnoses with the criteria based diagnoses was 66 ± 12% for those not given the criteria and 83 ± 4% (P <.01) for those given the criteria. Conclusions: The simple criteria of F waves in the frontal plane and a partially or completely regular ventricular response can be used to improve the differentiation of atrial flutter from atrial fibrillation based on the ECG.

Original languageEnglish (US)
Pages (from-to)814-818
Number of pages5
JournalAmerican Journal of Medicine
Volume120
Issue number9
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Atrial flutter
  • Electrocardiogram

ASJC Scopus subject areas

  • Medicine(all)

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