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Intracardiac/Electrogram from AVRT ablation depicting a ventricularly paced system alternating conduction between the atrioventricular node and accessory pathway

Description

An annotated intracardiac/electrogram from an atrioventricular reentrant tachycardia (AVRT) ablation procedure showing ventricular paced signals [red box] followed by retrograde ventricular conduction signals [blue box] before reaching the his-bundle and AVN for atrial conduction [green box]. The first series represents normal, concentric conduction up the ventricle to the node where atrial conduction spans out in either direction along the coronary sinus (CS) catheter. However, the second series represents abnormal, eccentric conduction down an accessory pathway originating from the CS 1,2 location correlating with the left atrial free-wall. Non-decremental conduction is seen in the accessory pathway as no pause occurs between ventricular and atrial signs [gap between blue/green boxes].

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