RHYTHM PUZZLE

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T.A. Simmers, A.A.M. Wilde

Figure 1.

63-year-old female was referred to our outpatient clinic with symptoms of palpitations. These had been occurring in paroxysms since 2002, and were highly drug refractory; she had undergone numerous A

T.A. Simmers A.A.M. Wlide Department of Cardiology, University Medical Centre, Amsterdam

DC cardioversions. Her ECG in sinus rhythm is shown in figure 1, during symptoms in figure 2, with a blowup in figure 3. Her prior history provides the solution to the following questions, which you might nonetheless try to answer without additional information. A. What diagnoses could the ECG in sinus rhythm suggest? B. What is your interpretation of figure 2

(aided by figure 3)?

Correspondence to: A.A.M. Wilde Department of Cardiology, University Medical Centre, P0 Box 22660, 1100 DD Amsterdam E-mail: [email protected]

466

Netherlands Heart Journal, Volume 13, Number 12, December 2005

(AP

RHYTHM PUZZLE

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