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Concealed atrial rhythms
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L e t t e r to the Editor:
Concealed Atrial Rhythms To the Editor: Dr. B a y , s de Luna and coworkers 1 present a case with concealed atrial electrical activity revealed b y intracardiac recordings and a specific electrocardiographic technique. They call attention to the extreme rareness of discovering concealed atrial rhythms. We would like to present a most unique case, where an atrial activity concealed in the surface leads could be revealed only by one of the intracardiac recordings. The tracing was obtained from a 45-yearold w o m a n with intermittent preexcitation and f r e q u e n t episodes of s u p r a v e n t r i c u l a r tachycardia. Tracings from top to bottom are: His bundle electrocardiogram/HBE/, low lateral right atrial electrogram/AE/, and chest lead 1/V1/. An almost regular atrial activity of sinus origin is a p p a r e n t in the V1 and in both intracardiac catheter recordings. In addition, there is a strictly r e g u l a r atrial f l u t t e r - l i k e a c t i v i t y w i t h cycle l e n g t h of 270 msec dissociated from propagated sinus
J. ELECTROCARDIOLOGY, VOL. 12, NO. 2, 1979
beats. This atrial "flutter" was concealed in all surface leads. The two parallel rhythms were always completely protected from each other. The localized atrial flutter was also operative during paroxysmal supraventricular tachycardia. Localized and concealed atrial flutter undisturbed by propagated sinus beats and by supraventricular tachycardia - - to our knowledge - - has not been described so far. JSzsef Tenczer, M.D. L~iszl5 Littmann, M.D. 3rd Department of Medicine, Semmelweis University of Medicine, EStvSs utca 12 H-1121 Budapest Hungary I. BAYES DE LUNA, A, BOADA, F X, CASELLAS, A, CREXELLS, C, DOMINQUEZ, J, MOLL, M G, JULIA, J, MARTRET,L, OTER, R, ROMAN,M AND VILAPLANA,J: Concealed Atrial Electrical Acitivity. J. Electrocardiol 11:301, 1978
L e t t e r to the Editor:
Concealed Atrial Rhythms To the Editor: Dr. B a y , s de Luna and coworkers 1 present a case with concealed atrial electrical activity revealed b y intracardiac recordings and a specific electrocardiographic technique. They call attention to the extreme rareness of discovering concealed atrial rhythms. We would like to present a most unique case, where an atrial activity concealed in the surface leads could be revealed only by one of the intracardiac recordings. The tracing was obtained from a 45-yearold w o m a n with intermittent preexcitation and f r e q u e n t episodes of s u p r a v e n t r i c u l a r tachycardia. Tracings from top to bottom are: His bundle electrocardiogram/HBE/, low lateral right atrial electrogram/AE/, and chest lead 1/V1/. An almost regular atrial activity of sinus origin is a p p a r e n t in the V1 and in both intracardiac catheter recordings. In addition, there is a strictly r e g u l a r atrial f l u t t e r - l i k e a c t i v i t y w i t h cycle l e n g t h of 270 msec dissociated from propagated sinus
J. ELECTROCARDIOLOGY, VOL. 12, NO. 2, 1979
beats. This atrial "flutter" was concealed in all surface leads. The two parallel rhythms were always completely protected from each other. The localized atrial flutter was also operative during paroxysmal supraventricular tachycardia. Localized and concealed atrial flutter undisturbed by propagated sinus beats and by supraventricular tachycardia - - to our knowledge - - has not been described so far. JSzsef Tenczer, M.D. L~iszl5 Littmann, M.D. 3rd Department of Medicine, Semmelweis University of Medicine, EStvSs utca 12 H-1121 Budapest Hungary I. BAYES DE LUNA, A, BOADA, F X, CASELLAS, A, CREXELLS, C, DOMINQUEZ, J, MOLL, M G, JULIA, J, MARTRET,L, OTER, R, ROMAN,M AND VILAPLANA,J: Concealed Atrial Electrical Acitivity. J. Electrocardiol 11:301, 1978