Serendipitous Supernormality
ABSTRACT We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation‐and‐drug‐refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.70069 |
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| author | Behzad B. Pavri Eitan Frankel |
| author_facet | Behzad B. Pavri Eitan Frankel |
| author_sort | Behzad B. Pavri |
| collection | DOAJ |
| description | ABSTRACT We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation‐and‐drug‐refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the VVIR mode at a faster pacing rate of 85 bpm. Serendipitously, this rate was an almost exact factorial of his flutter rate of 250–260 bpm. This resulted in every 6th flutter wave falling in the supernormal period, resulting in fixed‐coupled supraventricular bigeminy and trigeminy in the setting of complete heart block. Reprogramming the pacing rate to 75 bpm abolished bigeminy and trigeminy. |
| format | Article |
| id | doaj-art-40b8b27fd7d4418db7f5c4ef24d30ebe |
| institution | Kabale University |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-40b8b27fd7d4418db7f5c4ef24d30ebe2025-08-20T03:48:23ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-05-01303n/an/a10.1111/anec.70069Serendipitous SupernormalityBehzad B. Pavri0Eitan Frankel1Thomas Jefferson University Hospital Philadelphia Pennsylvania USAThomas Jefferson University Hospital Philadelphia Pennsylvania USAABSTRACT We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation‐and‐drug‐refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the VVIR mode at a faster pacing rate of 85 bpm. Serendipitously, this rate was an almost exact factorial of his flutter rate of 250–260 bpm. This resulted in every 6th flutter wave falling in the supernormal period, resulting in fixed‐coupled supraventricular bigeminy and trigeminy in the setting of complete heart block. Reprogramming the pacing rate to 75 bpm abolished bigeminy and trigeminy.https://doi.org/10.1111/anec.70069atrioventricular node ablationatypical atrial fluttersupernormal conduction |
| spellingShingle | Behzad B. Pavri Eitan Frankel Serendipitous Supernormality Annals of Noninvasive Electrocardiology atrioventricular node ablation atypical atrial flutter supernormal conduction |
| title | Serendipitous Supernormality |
| title_full | Serendipitous Supernormality |
| title_fullStr | Serendipitous Supernormality |
| title_full_unstemmed | Serendipitous Supernormality |
| title_short | Serendipitous Supernormality |
| title_sort | serendipitous supernormality |
| topic | atrioventricular node ablation atypical atrial flutter supernormal conduction |
| url | https://doi.org/10.1111/anec.70069 |
| work_keys_str_mv | AT behzadbpavri serendipitoussupernormality AT eitanfrankel serendipitoussupernormality |