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Figure 6 Spontaneous Onset of Atrial Flutter in a Patient
(Top panel) The ECG lead II recorded simultaneously with bipolar AEGs from the sulcus terminalis and Bachmann’s bundle. The * indicates a premature atrial beat that induces type II AFL (rate of 390 beats/min), which in turn causes AF (see ECG) due, we suggest, to fibrillatory conduction. (Bottom panel) The tracings are continuous with the top panel. Type II AFL persists in the AEGs, as does AF in the ECG, until AFL abruptly develops (*). We suggest that during the period of AF generated by the type II AFL, the functional components of the typical AFL re-entrant circuit evolved. Time lines at 1-s intervals. BBEG = electrogram from the Bachmann’s bundle; STEG = electrogram from the sulcus terminalis; other abbreviations as in Figure 5. Reprinted, with permission, from Waldo and Cooper (6).
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