Typical atrial flutter mimicking a pacemaker-mediated tachycardia

Academic Article


  • A 64-year-old man with a history of congestive heart failure secondary to nonischemic cardiomyopathy, mitral and aortic valve replacements, and biventricular cardioverter- defibrillator placement, developed a tachycardia. The tachycardia exhibited a biventricular paced rhythm with a short R-P interval and concentric atrial activation sequence within the coronary sinus, suggesting that the tachycardia might be a pacemaker-mediated tachycardia (PMT). However, the tachycardia was diagnosed as counterclockwise cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL), and linear ablation of the CTI eliminated the tachycardia. This case illustrated that typical AFL can mimic a PMT when there is a severe conduction delay through the CTI.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Yamada T; Kay GN
  • Start Page

  • 309
  • End Page

  • 311
  • Volume

  • 34
  • Issue

  • 3