This course will augment your ability to accurately diagnose atrial fibrillation and atrial flutter on the ECG. We explain how the underlying pathogenic mechanisms generating these arrhythmias result in predictable findings on the ECG. We discuss the importance of the detection of irregularity of rhythm in the diagnosis of atrial fibrillation. We explain the mechanism of decremental conduction by the AV node and teach you how to identify evidence of decremental conduction on the ECG in cases of atrial flutter. We illustrate the limitations of the computer interpretation (CI) reported on many ECG readouts in the diagnosis of these arrhythmias. We teach you the importance of overall clinical context and a high index of suspicion in diagnosing atrial flutter. We show you examples of conditions capable of mimicking atrial fibrillation on the ECG. In case studies, we show you how an experienced generalist approaches the ECG diagnosis of atrial fibrillation and atrial flutter.
Planner and Author: Dr John Seery MB PhD
Planner: Dr Karen Strahan PhD (University of Cambridge), Head of Editorial
Planner: Tommy O'Sullivan, CME Manager
2.0 hours
Upon successful completion of this activity, you will be able to:
28-MAY-2019
27-MAY-2022
Participants must complete the online activity during the valid period as noted above.
Follow these steps:
Acadoodle adheres to the ACCME's Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Planners and faculty for this activity have no relevant financial relationships with commercial interests to disclose.
Iwasaki Y et al. Atrial fibrillation pathophysiology: implications for management. Circulation 2011;124:2264-74.
https://www.ahajournals.org/doi/epub/10.1161/CIRCULATIONAHA.111.019893
Garcia TB and Garcia DJ. Arrhythmia recognition: the art of interpretation. 2nd edition. Jones and Bartlett learning, 5 Wall Street, Burlington, MA.
Kadish AH et al. ACC/AHA Clinical Competence Statement on Electrocardiography and Ambulatory Electrocardiography. Circulation 2001;104(25):3169-78.
https://pubmed.ncbi.nlm.nih.gov/11748119/
Khan R. Identifying and understanding the role of pulmonary vein activity in atrial fibrillation. Cardiovasc Res. 2004;64(3):387-94.
https://academic.oup.com/cardiovascres/article/64/3/387/324239
Lindow T et al. Erroneous computer-based interpretations of atrial fibrillation and atrial flutter in a Swedish primary health care setting. Scand J Prim Health Care. 2019;37(4):426-33. https://www.tandfonline.com/doi/full/10.1080/02813432.2019.1684429
Bui QA et al. Why do Computer Programs Misdiagnose Flutter? Am J Med. 2016;129(11):e289-e290
https://www.amjmed.com/article/S0002-9343(16)30725-2/pdf
Cosío FG. Atrial Flutter, Typical and Atypical: A Review. Arrhythm Electrophysiol Rev. 2017;6(2):55-62.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522718/
Bui QA et al. Why do Computer Programs Misdiagnose Flutter? Am J Med. 2016;129(11):e289-e290
https://www.amjmed.com/article/S0002-9343(16)30725-2/pdf
Seery JP and Ryan J. Why does atrial flutter fool us so often? Top ten tips to minimise uncertainty. https://acadoodle.com/articles/19
Seery JP and Ryan J. How to diagnose atrial fibrillation-top 5 tips.
https://www.acadoodle.com/articles/how-to-diagnose-atrial-fibrillation-top-5-tips
Acadoodle, Ltd is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Acadoodle, Ltd designates this enduring material activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The ECG Diagnosis of Atrial Fibrillation and Atrial Flutter
This course will improve your ability to accurately diagnose atrial fibrillation and atrial flutter on the ECG. We explain how the underlying pathogenic mechanisms generating these arrhythmias result in predictable findings on the ECG. We discuss the importance of the detection of irregularity of rhythm in the diagnosis of atrial fibrillation. We explain the mechanism of decremental conduction by the AV node and teach you how to identify evidence of decremental conduction on the ECG in cases of atrial flutter. We illustrate the limitations of the computer interpretation (CI) reported on many ECG readouts in the diagnosis of these arrhythmias. We teach you the importance of overall clinical context and a high index of suspicion in diagnosing atrial flutter. We show you examples of conditions capable of mimicking atrial fibrillation on the ECG. In case studies, we show you how an experienced generalist approaches the ECG diagnosis of atrial fibrillation and atrial flutter.
Planner and Author: Dr. John Seery, MB, PhD
Planner: Karen Strahan, PhD (Cantab), Head of Editorial
Planner: Tommy O'Sullivan, CME Manager
2 hours
Upon successful completion of this activity, you will be able to:
28-MAY-2019
28-MAY-2022
Participants must complete the online activity during the valid period as noted above.
Follow these steps:
Planners and faculty for this activity have no relevant financial relationships with commercial interests to disclose.
Bogun F et al. Misdiagnosis of atrial fibrillation and its clinical consequences. Am J Med 2004;117(9):636-42.
Garcia TB and Garcia DJ. Arrythmia recognition: the art of interpretation. 2nd edition. Jones and Bartlett learning, 5 Wall Street, Burlington, MA.
Kadish AH et al. ACC/AHA Clinical Competence Statement on Electrocardiography and Ambulatory Electrocardiography. Circulation 2001; 104:3169-78.
Khan R. Identifying and understanding the role of pulmonary vein activity in atrial fibrillation. Cardiovascular research 2004;64(3):387-94.
Nishida K et al. Atrial fibrillation pathophysiology: implications for management. Circulation 2011;124:2264-74.
Seery JP and Ryan J. Why does atrial flutter fool us so often? Top ten tips to minimise uncertainty. https://acadoodle.com/articles/why-does-atrial-flutter-fool-us-so-often-top-10-tips-to-minimize-uncertainty
Seery JP and Ryan J. How to diagnose atrial fibrillation-top 5 tips. https://acadoodle.com/articles/how-to-diagnose-atrial-fibrillation-top-5-tips
Shiyovich A et al. Accuracy of diagnosing atrial flutter and atrial fibrillation from a surface electrocardiogram by hospital physicians: analysis of data from internal medicine departments. Am J Med Sci 2010;340(4):271-5.
Smulyan H. The Computerised ECG: Friend and Foe. Am J Med 2019 132:153-60.
Waldo AL. Mechanism of atrial flutter and atrial fibrillation: distinct entities or two sides of a coin? Cardiovascular research 2002;54(2):217-29.
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