TY - JOUR
AU1 - TEMPLE, IAN P.
AU2 - FITCHET, ALAN
AU3 - FOX, DAVID J.
AB -  Case Presentation A 43‐year‐old patient presented to the emergency room with palpitations; her initial electrocardiogram (ECG) is shown ( Fig. 1 ). She had no comorbidities or significant past medical history, was not on any medications, and was hemodynamically stable. 1 (A) Presentation ECG. (B) ECG on reversion to sinus rhythm after flecanide infusion. She was diagnosed with atrial fibrillation (AF) in the emergency room and commenced on a flecainide infusion. She reverted to sinus rhythm after 25 minutes ( Fig. 1 ). Routine blood tests including thyroid function were unremarkable and an echocardiogram revealed no structural abnormalities. She was commenced on oral flecainide and bisoprolol and then discharged home. She continued to have problems with palpitations and tachycardia and therefore her cardiologists stopped her medications and referred her to our service for consideration of a pulmonary vein isolation procedure. What is the mechanism of this tachycardia? What treatment should be offered? Is any further investigation/testing required before treatment? Discussion Careful analysis of the initial ECG reveals two interesting features which are highlighted in Figure 2 . The first is the presence of retrograde P waves inscribed on the end of the QRS complexes. The retrograde P waves 
TI - Irregular Narrow Complex Tachycardia: What Is the Mechanism?
JF - Pacing and Clinical Electrophysiology
DO - 10.1111/j.1540-8159.2012.03456.x
DA - 2012-09-01
UR - https://www.deepdyve.com/lp/wiley/irregular-narrow-complex-tachycardia-what-is-the-mechanism-AP4UTZ0nuS
SP - 1154
VL - 35
IS - 9
DP - DeepDyve
ER -