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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

Upper panel shows the same SVC tachycardia being conducted 1:1 to the atria (red arrow) which precedes onset of atrial fibrillation. Lower panel shows the SVC tachycardia being unperturbed by ongoing atrial fibrillation.
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fig3: Upper panel shows the same SVC tachycardia being conducted 1:1 to the atria (red arrow) which precedes onset of atrial fibrillation. Lower panel shows the SVC tachycardia being unperturbed by ongoing atrial fibrillation.

Mentions: Occasionally, SVC-RA conduction would intermittently improve, allowing for 1:1 SVC-RA conduction (Fig. 3 upper panel). Acceleration of the atrial rate precedes initiation of AF. During AF, electrical activation within the SVC remains regular, suggestive of “retrograde” RA to SVC conduction block, preventing overdrive termination of SVC tachycardia (Fig. 3 lower panel).


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

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

Upper panel shows the same SVC tachycardia being conducted 1:1 to the atria (red arrow) which precedes onset of atrial fibrillation. Lower panel shows the SVC tachycardia being unperturbed by ongoing atrial fibrillation.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig3: Upper panel shows the same SVC tachycardia being conducted 1:1 to the atria (red arrow) which precedes onset of atrial fibrillation. Lower panel shows the SVC tachycardia being unperturbed by ongoing atrial fibrillation.
Mentions: Occasionally, SVC-RA conduction would intermittently improve, allowing for 1:1 SVC-RA conduction (Fig. 3 upper panel). Acceleration of the atrial rate precedes initiation of AF. During AF, electrical activation within the SVC remains regular, suggestive of “retrograde” RA to SVC conduction block, preventing overdrive termination of SVC tachycardia (Fig. 3 lower panel).

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