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Figure 4 PAC response in JT
The same patient as shown in Figure 3 had this rhythm after radiofrequency ablations for atrioventricular node re-entry tachycardia. Early PAC (S2) advances the immediate His by 44 ms, and the tachycardia continues. The red arrow (A) points to the local atrial activation on the His recording catheter that occurs before the His bundle activation. This advancement of the immediate His by a PAC with continuation of tachycardia indicates junctional tachycardia as the mechanism, and further ablations are not necessary. The measurements in milliseconds (ms) are H-H intervals. Abbreviations as in Figure 3.
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