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Progressive ECG changes before the onset of atrial flutter in adult congenital heart disease patients
  1. WEI LI,
  2. HAN B XIAO,
  1. Royal Brompton Hospital and
  2. Imperial College School of Medicine
  3. London University, UK
  1. Dr Derek Gibson, Cardiology Department, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK

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Atrial flutter is a frequent complication in patients with adult congenital heart disease either during natural history or after surgical repair.1 ,2 The incidence of such an arrhythmia increases postoperatively with time and is usually associated with complex atrial surgery.3 ,4 When it occurs, atrial flutter compromises haemodynamics, reduces exercise tolerance, and is often resistant to medical treatment. The P wave has been found to change its electrical characteristics before atrial fibrillation supervenes in patients with coronary artery disease.5 We sought to study the same hypothesis in 39 adult congenital heart disease patients, 31% of them with Mustard or Fontan surgery, who developed atrial flutter long …

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