Premature ventricular contraction response-induced new-onset atrial fibrillation Daniel J. Friedman, MD, Tiffany Chasten, RN, Kenya Anderson, RN, Jessica.

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Presentation transcript:

Premature ventricular contraction response-induced new-onset atrial fibrillation Daniel J. Friedman, MD, Tiffany Chasten, RN, Kenya Anderson, RN, Jessica Mullenix, AGNP, Kimberly Rider, RN, Albert Y. Sun, MD HeartRhythm Case Reports Volume 5, Issue 3, Pages 120-123 (March 2019) DOI: 10.1016/j.hrcr.2018.11.012 Copyright © 2018 Terms and Conditions

Figure 1 Representative device electrogram showing how the atrial pace premature ventricular contraction response (arrow) resulted in a long–short sequence and eventually atrial fibrillation due to an intrinsic atrial event occurring late in the extended postventricular atrial refractory period. RV = right ventricle. HeartRhythm Case Reports 2019 5, 120-123DOI: (10.1016/j.hrcr.2018.11.012) Copyright © 2018 Terms and Conditions

Figure 2 After the atrial pace premature ventricular contraction (PVC) response algorithm was disabled, PVCs occurred without closely coupled atrial pacing. Of note, the intrinsic atrial activity early in the extended postventricular atrial refractory period likely would be too early to result in long–short induced atrial fibrillation even if the PVC response had remained on. LV = left ventricle; RV = right ventricle. HeartRhythm Case Reports 2019 5, 120-123DOI: (10.1016/j.hrcr.2018.11.012) Copyright © 2018 Terms and Conditions

Figure 3 Plot of atrial fibrillation (AF) episode frequency showing an abrupt drop in AF episodes occurring at the time of reprogramming the premature ventricular contraction response algorithm off (star and vertical dashed line). AT = atrial tachycardia. HeartRhythm Case Reports 2019 5, 120-123DOI: (10.1016/j.hrcr.2018.11.012) Copyright © 2018 Terms and Conditions