Case 4: An 82 Year-Old Man in Pacemaker Clinic for Routine Assessment
History
Diagnosis
ECG 2
ECG 2 Diagnosis
History
An 87 year-old man presents to the pacemaker clinic for routine assessment and is noted to have several episodes of tachycardia. On questioning, he has been completely asymptomatic. One of the episodes of tachycardia are shown below:
Diagnosis
- Initially Sinus Rhythm
- Abrupt onset of tachycardia with 1:1 AV relation followed by abrupt termination
Electrograms of the Tachycardia are shown on the the following tab (ECG 2)
ECG 2
Shown below are the electrograms corresponding to the onset of the tachycardia:
ECG 2 Diagnosis
- Premature atrial complex (noted as “P” below)
- Initiation of short RP tachycardia
Comment: The short RP tachycardia (QRS to P interval is shorter than P to QRS interval) is suggestive of either AVNRT or AVRT, although an atrial tachycardia cannot be ruled out. Given the patient was asymptomatic and the episodes were all shorter than a few minutes, no intervention was undertaken.
ECG ID: E830