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Exercise intolerance due to sustained atrial bigeminy with short coupling interval.
Katrijn Jansen1, Dominique Blommaert, Olivier Deceuninck
1Department of Cardiology, UCL Mont Godinne, Yvoir, Belgium. Katrijnjansen@hotmail.com
Acta Cardiologica
|September 8, 2011
Summary
Atrial bigeminy, a rare heart rhythm disorder, can cause severe symptoms like exercise intolerance. Catheter ablation of a right atrial ectopic focus successfully treated a young woman with this condition.
Area of Science:
- Cardiology
- Electrophysiology
- Arrhythmology
Background:
- Atrial bigeminy is a supraventricular arrhythmia infrequently linked to significant symptoms.
- This case examines a young patient with previously unrecognized cardiac disease.
Observation:
- A 22-year-old woman presented with several months of exercise intolerance.
- Cardiac examination revealed no significant heart disease, only spontaneous atrial bigeminy with a short coupling interval.
- Exercise testing demonstrated inadequate heart rate response and symptom exacerbation due to sustained atrial bigeminy.
Findings:
- Electrophysiological study identified an ectopic atrial focus in the right atrial septum as the source of the arrhythmia.
- Radiofrequency catheter ablation successfully eliminated the ectopic focus and the atrial bigeminy.
Implications:
- This case highlights that even rare arrhythmias like atrial bigeminy can manifest with significant symptoms, particularly exercise intolerance.
- Successful ablation of the ectopic focus provides a curative treatment option for symptomatic atrial bigeminy.
- It underscores the importance of electrophysiological evaluation in patients with unexplained exercise intolerance and arrhythmias.
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