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- W2072281034 abstract "A 30-year-old man with a 15-year history of intermittent palpitations and sensation of “extra beats” was admitted for an electrophysiological study. Baseline conduction intervals were normal. Concentric, decremental retrograde activation was observed and dual AV nodal physiology with single echo beats during the antegrade curve. Programmed electrical stimulation and burst pacing while on an isoprenaline infusion revealed single echo beats only. During the isoprenaline “washout” phase, however, frequent monomorphic atrial ectopic beats were seen. The P wave was inverted in the inferior leads; inverted in V1 and across the precordium; upright in aVL and isoelectric in lead I. This morphology is suggestive of an origin at the inferior tricuspid annulus (Fig. 1). Mapping of the inferior tricuspid annulus with the ablation catheter demonstrated focally located concealed bigeminal activity with fixed coupling interval to the preceding sinus beat (Fig. 2). Occasionally this concealed activity would conduct and initiate an atrial ectopic beat. On conducted beats the high-frequency activity was 105 ms pre-P wave. Radiofrequency ablation at the site of the high-frequency activity at the inferior tricuspid annulus resulted in atrial speeding with the same morphology as the atrial ectopic beats. With continued RF delivery, atrial speeding slowed and terminated. Following ablation, the high-frequency potential had disappeared and no further atrial ectopy could be elicited. At latest follow-up, the patient had complete resolution of recurrent palpitations." @default.
- W2072281034 created "2016-06-24" @default.
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- W2072281034 date "2013-04-11" @default.
- W2072281034 modified "2023-10-17" @default.
- W2072281034 title "Concealed Atrial Ectopic Focus Originating from the Tricuspid Annulus" @default.
- W2072281034 doi "https://doi.org/10.1111/jce.12144" @default.
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