Modulation of ECG atrial flutter wave amplitude by heart motion: A model-based and a bedside estimate

This paper reports two attempts at estimating the magnitude of atrial flutter amplitude modulation caused by atrial motion during heart contraction. The first approach consists in analyzing the ECG of a patient in flutter with atrioventricular block and an implanted pacemaker. These conditions facilitate QRST cancellation, even in the presence of time-varying flutter wave amplitude. The second approach is based on a computer model of atrial flutter embedded in a torso model featuring predetermined motion of the atria. The results suggests that this lead-dependent effect is usually not large enough to preclude reasonably accurate QRST cancellation or T-wave extraction.