CHALLENGE OF THE WEEK See Answer to January 15th Following Question Amit Noheria, MBBS, SM Where would you anticipate ablating the premature complexes shown on 12-lead ECG in Figure 1? Figure 1. Standard 12-lead electrocardiogram in a young patient with symptomatic ectopic beats. Answer Options A. Aortomitral continuity B. Mitral valve annulus C. Tricuspid valve annulus D. Left ventricular septum E. Left ventricular papillary muscle Circ Arrhythm Electrophysiol is available at http://circep. ahajournals.org. © 2018 American Heart Association, Inc. Circ Arrhythm Electrophysiol. 2018;11:e006205. DOI: 10.1161/CIRCEP.118.006205 February 2018 1 Noheria; Challenge of the Week ANSWER TO JANUARY 15th QUESTION D. Ventricular pacing induces antegrade atrioventricular sustains because all atrial events are retrograde P (AV) conduction block waves, and there is no captured P wave to gener- ate antegrade conducted QRS complex. Option D is false because there is no evidence of antegrade AV block. As shown in the figure, the episode begins with a premature atrial complex (*) sensed during postventricular atrial refractory period (350 ms), thus not inhibiting subsequent A pacing output. The atrial pacing output occurs determined by the lower rate limit (750 ms after previous atrial pace output). The conducted QRS from the premature atrial complex, however, incidentally
Circulation: Arrhythmia & Electrophysiology – Wolters Kluwer Health
Published: Feb 1, 2018
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