Typical atrial flutter mimicking a pacemaker-mediated tachycardia

Takumi Yamada, George Neal Kay

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)309-311
Number of pages3
JournalJournal of Arrhythmia
Issue number3
StatePublished - Jun 1 2018


  • Catheter ablation
  • Cavotricuspid isthmus
  • Intra-atrial conduction delay
  • Pacemaker-mediated tachycardia
  • Typical atrial flutter

Fingerprint Dive into the research topics of 'Typical atrial flutter mimicking a pacemaker-mediated tachycardia'. Together they form a unique fingerprint.

Cite this