Document Type

Report

Publication Date

5-1-2025

Comments

This article is the author's final published version in Annals of Noninvasive Electrocardiology, Volume 30, Issue 3, 2025, Article number e70069.

The published version is available at https://doi.org/10.1111/anec.70069.

Copyright © 2025 The Author(s)

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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Language

English

PubMed ID

40181525

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