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October 10, 1953

NATURE OF SPONTANEOUS AURICULAR FLUTTER IN MANREPORT OF A CASE OBSERVED DIRECTLY DURING CARDIAC SURGERY

JAMA. 1953;153(6):553-555. doi:10.1001/jama.1953.02940230025006e
Abstract

The mechanism of auricular flutter has become a subject of increasing controversy during the past several years. In 1887, McWilliam introduced the term "flutter" to describe an experimentally produced disturbance in the dog's heart and suggested that the arrhythmia consisted of recurrent impulses radiating in all directions from a single ectopic focus. Subsequent investigators developed the concept of "circulating rhythms," which, in 1918, was applied to the fluttering auricles in man and experimental animals by Sir Thomas Lewis. Lewis' classic circus movement theory was not seriously questioned until 1932, when Brams and Katz reported that flutter produced by electric stimulation failed to end after the hypothetical circus pathway was severed. Certain mathematical inconsistencies in Lewis' calculations were noted by Weiner and Rosenblueth in 1946 and by Selfridge in 1948. Scherf's studies of aconitine-produced flutter, during 1948 and 1949, revealed that cooling or clamping of the aconitine focus restored normal sinus

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