Nine cases of alternation of the atrial cycles during supraventricular tachycardia are presented, three of which were manifestly due to digitalis toxicity. They presented the following features: absence of 1/1 conduction, upright P waves in Lead II, atrial rates of 156-218. When alternation disappeared, the atrium adopted the longest of the previously inscribed cycles. A ventriculophasic cause was excluded. The possible mechanisms are discussed in terms of the known functional anatomy of the various forms of SVT.
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