Induction of nonsustained atrial flutter by programmed atrial stimulation in children: Incidence, mechanisms, and clinical implications

Alfonso Casta, Grace S. Wolff, Askok V. Mehta, Dolores F. Tamer, Arthur S. Pickoff, Henry Gelband

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Nonsustained atrial flutter was induced by programmed atrial extrastimulation in 6 (4%) of 137 children with preoperative congenital heart defects, who underwent electrophysiologic evaluation as part of cardiac catheterization. None of these patients had ECG or clinical evidence of arrhythmias. Atrial reentry was induced by programmed atrial extrastimulation in these six patients at coupling intervals slightly longer than the coupling interval at which flutter was induced. The flutter cycle length was similar to the atrial refractory periods. The duration ranged between 0.4 second and 60 seconds. The PA interval and the duration of the P wave were normal in all of the patients. Five of the six had normal PR intervals. It is concluded that nonsustained atrial flutter may be induced by programmed atrial extrastimulation in dysrhythmia-free children. The cycle length is determined by atrial refractoriness and, contrary to adults with clinical atrial flutter, prolonged PA and P wave duration are not predisposing factors.

Original languageEnglish (US)
Pages (from-to)444-448
Number of pages5
JournalAmerican Heart Journal
Volume107
Issue number3
DOIs
StatePublished - Mar 1984

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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