Palpitations Again, Have a Closer Look

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Author(s) A.A.M. Wilde, L.R.C. Dekker
NHJ edition: 2006:11,393
These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.
The ECG can be enlarged twice by clicking on the image and it's first enlargement
Figure 1. The ECG on admission
Figure 2. The ECG shortly thereafter

An otherwise healthy 57-year-old lady presented with palpitations without dizziness. The symptoms had been present for a couple of years but the number of episodes had increased recently. Onset and termination were always sudden without specific triggers. Physical examination on admission revealed no specific abnormalities except for a rapid pulse (150 beats/min). Blood pressure was normal. The ECG is shown in figure 1 and a few minutes later figure 2 was recorded without any specific intervention.

What is your diagnosis?

Answer