Unusual Case of Atrial Tachycardia
Author Information
Author(s): Hanon Sam, Shapiro Michael, Schweitzer Paul
Primary Institution: Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine
Hypothesis
Can the atrial electrogram from a pacemaker help in diagnosing atrial tachycardia when P waves are not clear on an ECG?
Conclusion
The atrial electrogram confirmed the diagnosis of atrial tachycardia despite the absence of clear P waves on the ECG.
Supporting Evidence
- The patient had a history of aortic stenosis and atrial fibrillation.
- The initial ECG showed wide complex tachycardia at 170 bpm.
- The follow-up ECG revealed a ventricular rate of 85 bpm with no clear P wave activity.
- The pacemaker interrogation confirmed atrial tachycardia with a 2:1 block.
Takeaway
A doctor found that a patient's heart was beating too fast, but the usual tests didn't show why. They used a special device to look closer and figured out it was a specific type of fast heartbeat.
Methodology
The patient's pacemaker was interrogated to analyze the rhythm and confirm the diagnosis.
Limitations
The case is based on a single patient, which may limit the generalizability of the findings.
Participant Demographics
Eighty-four year old Dominican man.
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