{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T07:48:04Z","timestamp":1781077684021,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2010,3,31]],"date-time":"2010-03-31T00:00:00Z","timestamp":1269993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the value of changes in P wave morphology and duration detected by surface electrocardiogram (ECG) during proximal coronary sinus (PCS) and low lateral right atrial (LLRA) stimulation as a marker for complete bidirectional isthmus conduction block in the procedure of typical atrial flutter ablation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Morphology, duration, and ratio of a positive terminal P wave were estimated in 52 typical atrial flutter patients before and after radiofrequency catheter ablation (RFCA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Atrial flutter ablation resulted in a complete bidirectional isthmus block in all 52 patients. The terminal portion of the P wave towards a positive morphology was detected in 90.7% (47\/52) patients both during PCS and LLRA stimulation. These changes were predominantly observed in the inferior leads. Positive morphological changes of the terminal P wave portion and the measured P wave ratio (40% \u00b1 12%) in the inferior leads indicating bidirectional isthmus conduction block with a sensitivity of 87.5% and a specificity of 91.7% were observed. An increment of 20 ms or more in P wave duration during the PCS stimulation and 10 ms or more during the LLRA stimulation indicating the conduction block with a sensitivity of 90% and a specificity of 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The variation of P wave morphology and duration in inferior leads of the surface ECG is a helpful technique to assess the complete bidirectional isthmus conduction block in the procedure of typical atrial flutter ablation. Copyright \u00a9 2010 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.20479","type":"journal-article","created":{"date-parts":[[2010,3,31]],"date-time":"2010-03-31T19:03:03Z","timestamp":1270062183000},"source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the Surface ECG in Detecting Isthmus Conduction Block after Ablation of Typical Atrial Flutter"],"prefix":"10.1002","volume":"33","author":[{"given":"Su\u2010hua","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010juan","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010you","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He\u2010sheng","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,3,31]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.4.1233"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)91014-9"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1999.tb00349.x"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2001.00169.x"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1161\/01.CIR.89.3.1074","article-title":"Radiofrequency catheter ablation of atrial arrhythmias. 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