TY - JOUR T1 - Progressive ECG changes before the onset of atrial flutter in adult congenital heart disease patients JF - Heart JO - Heart SP - 703 LP - 703 DO - 10.1136/heart.85.6.703 VL - 85 IS - 6 AU - WEI LI AU - HAN B XIAO AU - MICHAEL Y HENEIN AU - JANE SOMERVILLE AU - DEREK G GIBSON Y1 - 2001/06/01 UR - http://heart.bmj.com/content/85/6/703.1.abstract N2 - 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 … ER -