P-P cycle alternans during atrial tachycardia can be observed on ambulatory ECG and may indicate longitudinal dissociation within the atrial circuit.
P-P cycle alternans on ECG may reflect atrial dissociation in SVT; leaves open mechanistic and therapeutic implications pending larger studies.
Background: A‐63 year‐old man complaining of palpitations underwent a 24‐hour ambulatory ECG monitoring that revealed the presence of recurrent episodes of nonsustained supraventricular tachycardia. Analysis of the tracings suggests an atrial origin of the arrhythmia. Tachycardias, quite regular at the beginning, suddenly showed a P‐P cycle alternans, namely, P‐P intervals alternately short and long. The evidence of two separate cycle ranges can be explained by the presence of a longitudinal dissociation within a discrete zone of the atrial circuit.
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Satullo et al. (2000) studied this question.
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