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4:2:1 conduction of an AF initiating trigger.

Kojodjojo P, Chong E, Lim TW, Seow SC - Indian Pacing Electrophysiol J (2015)

Bottom Line: Earliest activation was mapped to a focus in the superior vena cava (SVC) which was conducted in a 2:1 ratio to the atria which in turn was conducted with 2:1 ratio to the ventricles, resulting in an unusual 4:2:1 conduction of the SVC tachycardia. 1:1 conduction of the SVC tachycardia to the atrium preceded initiation of AF.During AF, SVC tachycardia continued unperturbed.Sinus rhythm was restored following catheter ablation of the focus.

View Article: PubMed Central - PubMed

Affiliation: National University Heart Centre, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore.

ABSTRACT
A 44 year old male with idiopathic dilated cardiomyopathy was undergoing persistent atrial fibrillation (AF) ablation. Following antral ablation, AF terminated into a regular narrow complex rhythm. Earliest activation was mapped to a focus in the superior vena cava (SVC) which was conducted in a 2:1 ratio to the atria which in turn was conducted with 2:1 ratio to the ventricles, resulting in an unusual 4:2:1 conduction of the SVC tachycardia. 1:1 conduction of the SVC tachycardia to the atrium preceded initiation of AF. During AF, SVC tachycardia continued unperturbed. Sinus rhythm was restored following catheter ablation of the focus.

No MeSH data available.


Related in: MedlinePlus

Intracardiac electrograms from high right atrium (HRA), mid right atrium (MRA), low right atrium (LRA), proximal coronary sinus (PCS), middle coronary sinus (MCS) and circular mapping catheter (CMC).
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fig2: Intracardiac electrograms from high right atrium (HRA), mid right atrium (MRA), low right atrium (LRA), proximal coronary sinus (PCS), middle coronary sinus (MCS) and circular mapping catheter (CMC).

Mentions: The 12 lead ECG demonstrates a regular narrow complex rhythm at 75 beats per minute (bpm). Closer inspection of the ECG reveals the presence of non-conducted P waves (most visible in V1, superimposed on T waves), establishing the diagnosis of an atrial tachycardia with 2:1 AV conduction. The P-wave morphology is consistent with a high right atrial focus and therefore the circular mapping catheter (CMC) was positioned at the superior vena cava (SVC) – right atrium (RA) junction. The intracardiac electrograms in Fig. 2 indicate the presence of a rapid SVC tachycardia (300 bpm) with 2:1 conduction to the atrium (150 bpm) which in turn conducted in a 2:1 ratio to the ventricle, resulting in a 4:2:1 conduction pattern.


4:2:1 conduction of an AF initiating trigger.

Kojodjojo P, Chong E, Lim TW, Seow SC - Indian Pacing Electrophysiol J (2015)

Intracardiac electrograms from high right atrium (HRA), mid right atrium (MRA), low right atrium (LRA), proximal coronary sinus (PCS), middle coronary sinus (MCS) and circular mapping catheter (CMC).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834426&req=5

fig2: Intracardiac electrograms from high right atrium (HRA), mid right atrium (MRA), low right atrium (LRA), proximal coronary sinus (PCS), middle coronary sinus (MCS) and circular mapping catheter (CMC).
Mentions: The 12 lead ECG demonstrates a regular narrow complex rhythm at 75 beats per minute (bpm). Closer inspection of the ECG reveals the presence of non-conducted P waves (most visible in V1, superimposed on T waves), establishing the diagnosis of an atrial tachycardia with 2:1 AV conduction. The P-wave morphology is consistent with a high right atrial focus and therefore the circular mapping catheter (CMC) was positioned at the superior vena cava (SVC) – right atrium (RA) junction. The intracardiac electrograms in Fig. 2 indicate the presence of a rapid SVC tachycardia (300 bpm) with 2:1 conduction to the atrium (150 bpm) which in turn conducted in a 2:1 ratio to the ventricle, resulting in a 4:2:1 conduction pattern.

Bottom Line: Earliest activation was mapped to a focus in the superior vena cava (SVC) which was conducted in a 2:1 ratio to the atria which in turn was conducted with 2:1 ratio to the ventricles, resulting in an unusual 4:2:1 conduction of the SVC tachycardia. 1:1 conduction of the SVC tachycardia to the atrium preceded initiation of AF.During AF, SVC tachycardia continued unperturbed.Sinus rhythm was restored following catheter ablation of the focus.

View Article: PubMed Central - PubMed

Affiliation: National University Heart Centre, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Level 9, 119228, Singapore.

ABSTRACT
A 44 year old male with idiopathic dilated cardiomyopathy was undergoing persistent atrial fibrillation (AF) ablation. Following antral ablation, AF terminated into a regular narrow complex rhythm. Earliest activation was mapped to a focus in the superior vena cava (SVC) which was conducted in a 2:1 ratio to the atria which in turn was conducted with 2:1 ratio to the ventricles, resulting in an unusual 4:2:1 conduction of the SVC tachycardia. 1:1 conduction of the SVC tachycardia to the atrium preceded initiation of AF. During AF, SVC tachycardia continued unperturbed. Sinus rhythm was restored following catheter ablation of the focus.

No MeSH data available.


Related in: MedlinePlus