Criteria for the Electrocardiographic Diagnosis of Atrial Flutter Improve Diagnostic Accuracy

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• 作者：Kenneth M. Weinberg ; Pablo Denes ; Alan H. Kadish ; Jeffrey J. Goldberger
• 关键词：Atrial flutter ; Atrial fibrillation ; Electrocardiogram
• 刊名：The American Journal of Medicine
• 出版年：2007
• 出版时间：September 2007
• 年：2007
• 卷：120
• 期：9
• 页码：814-818
• 全文大小：442 K

文摘

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.