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A case showing atrial dissociation and other various kinds of arrhythmias
Japanese Heart Journal
|May 1, 1978
Insights
This case study shows atrial dissociation after isoproterenol use in complete atrioventricular block. A rapid atrial flutter in the left atrium alone was suggested by unique P wave findings.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Complete atrioventricular block presents challenges in heart rate management.
- Isoproterenol is used to increase heart rate but can have complex effects on atrial activity.
Observation:
- A patient with complete atrioventricular block received oral isoproterenol to augment heart rate.
- Two distinct P wave morphologies were observed on electrocardiogram (ECG).
Findings:
- Atrial dissociation was identified following isoproterenol administration.
- One P wave type showed a small upward deflection, while another exhibited a deep, downward, spike-like deflection.
- The rapid, spike-like P waves occurred at a rate of 300 beats/min, indicative of atrial flutter confined to the left atrium.
Implications:
- This case highlights a rare complication of isoproterenol use in AV block.
- The findings suggest that isoproterenol can induce localized atrial arrhythmias.
- Understanding atrial dissociation is crucial for managing complex bradyarrhythmias and drug-induced arrhythmias.
Abstract:
A case is reported in which atrial dissociation occurred after oral isoproterenol administration to increase the heart rate in the presence of complete atrioventricular block. Two types of P wave, one with small upward deflection and the other with deep downward spike-like deflection, were present. The latter wave appeared at a high rate of 300/min, suggesting the existence of atrial flutter in the left atrium alone.