Recurrent ectopic junctional tachycardia in Ebstein's anomaly. Case report of a 67-year-old man

We reported the case of a 67-year-old man with Ebstein's anomaly, the oldest patient with this disease in Japan as far as we know. His condition was often accompanied by ectopic junctional tachycardia with isorhythmic AV dissociation, which made him complain of palpitation by elevating right intra-atrial pressure. Although enhanced automaticity was the most likely mechanism of this tachycardia, it was abruptly initiated and terminated by a single premature contraction. Because this interesting character can not be explained solely by the usual ideas of automaticity, we suggest that ectopic junctional tachycardia in the present case may somewhat resemble the phenomenon of triggered automaticity.