The underlying mechanism for stable beat-to-beat cycle length variability (CL alternans) in scar-related atrial tachycardia (AT) had not been elucidated clearly. We described a case with postoperative dual-loop reentrant AT in right atrium. When the loop depended on cavo-tricuspid isthmus was blocked by ablation, the AT transformed into a CL alternate tachycardia. High density and resolution mapping revealed that the CL alternans was caused by the alternate conduction velocities at the slow conduct region. A further ablation line was created from the slow conduction zone to the inferior vena cave, and afterward no AT was inducible.

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http://dx.doi.org/10.1002/joa3.12177DOI Listing

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