Narrow Complex Tachycardia With Alternating R-R intervals. What is the mechanism?

oleh: David Foo, KS Ng, Lucy Qu, Antonio Sutandar

Format: Article
Diterbitkan: Elsevier 2006-10-01

Deskripsi

A 25 year old man underwent electrophysiology study for recurrent symptomatic paroxysmal palpitations. There were no documented episodes of supraventricular tachycardia on surface ECG. Delta waves were absent on baseline ECG. A decapolar catheter was placed in the coronary sinus with the distal and proximal pair of electrodes configured as CS 1-2 and CS 9-10 respectively. Quadripolar catheters were positioned in the high right atrium, His-bundle region and right ventricular apex. During straight atrial pacing with a drive-cycle length of 340ms, the following arrhythmia was induced (Figure 1). The corresponding electrogram is shown in Figure 2. What is the mechanism?