Mitral valve surgery: The risk of atrial tachycardia, but not atrial fibrillation, depends on the type of surgical approach

Abstract

atypical AFL in XY (p 0.008), YZ (p 10) and XZ (p 10) planes (figure), and rotated planes: aVR/III (p 0.0004), III/V1 (p 10), aVR/V1 (p 10). Notably, we were able to separate forms of atypical AFL in this fashion. Atypical right AFL showed significantly greater XY coherence than atypical left AFL (0.80 0.13 vs 0.52 0.40; p 0.02), and atypical left AFL was most coherent in a clockwise-rotated XY plane (aVL/II; 0.71 0.18; p 0.02 vs aVL/V1, II/V1). Importantly, coherence did not correlate with F-wave amplitude, suggesting that non-preferred planes did not simply reflect small F-waves. Conclusions: Atypical AFL shows less spatial coherence than typical AFL, especially in YZ and XZ planes. Moreover, ‘rotating’ the XY plane (aVL/II) enabled separation of left from right atypical AFL. Temporospatial ECG analysis provides spatial insights into atypical macro-reentry and may guide the approach to ablation.