ECG lead II recorded from a patient with typical atrial flutter (spontaneous atrial cycle length of 264 ms). ECG lead II recorded from a patient with typical.

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Date of download: 7/7/2016 Copyright © The American College of Cardiology. All rights reserved. From: Endocardial and Epicardial Repolarization Alternans.

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Presentation transcript:

ECG lead II recorded from a patient with typical atrial flutter (spontaneous atrial cycle length of 264 ms). ECG lead II recorded from a patient with typical atrial flutter (spontaneous atrial cycle length of 264 ms). Rapid atrial pacing from a high right atrial site at a cycle length of 254 ms (not shown), at a cycle length of 242 ms (not shown), and at a cycle length of 232 ms (not shown) failed to terminate the atrial flutter. Panel A shows ECG lead II recorded during high right atrial pacing at a cycle length of 224 ms. Note that with the seventh atrial beat in this tracing, and after 22 seconds of atrial pacing at a constant rate, the atrial complexes suddenly became positive. Panel B shows ECG lead II recorded at the termination of atrial pacing in the same patient. Note that with abrupt termination of pacing, sinus rhythm occurs. In panel C, the first beat (asterisk) is identical to the last beat in panel B (asterisk). S, stimulus artifact. Time lines are at 1 second intervals. Modified from Waldo AL, et al. Circulation 1997;56:737–45. Albert L Waldo Heart 2000;84:227 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.