Challenges in Clinical Electrocardiography | ONLINE FIRST

Dual Ventricular Rhythm—Diagnosis ONLINE FIRST

JAMA Intern Med. Published online June 03, 2013. doi:10.1001/jamainternmed.2013.7043b
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Correspondence: Raul D. Mitrani, MD, Division of Cardiology, University of Miami Miller School of Medicine, 1400 NW 12th Ave, Ste 4062, Miami, FL 33136 (rmitrani@med.miami.edu).

Published Online: June 3, 2013. 10.1001/jamainternmed.2013.7043a 10.1001/jamainternmed.2013.7043b

Conflict of Interest Disclosures: Dr Mitrani has a consultant relationship with St Jude Medical and Medtronic Inc.

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Graphic Jump Location

Figure 2. A 12-lead electrocardiogram (ECG) demonstrating adjacent broad and narrow QRS complexes with opposite polarity representing 2 different rhythms in the same ECG (white arrows in lead II represent transplanted heart rhythm and black arrows in lead II represent left bundle branch block morphologic rhythm of the native heart). Frequent premature ventricular contractions were observed in lead V1 (gray arrow) along the wide QRS complex rhythm (transplanted heart).

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Graphic Jump Location

Figure 3. Layout of the heterotopic heart transplant. A, Pictorial representation of the transplant and the respective anastomosis. B, Computed tomography of the chest (coronal view) in our patient, showing marked respective chambers and anastomosis (demonstrating the end-to-side anastomosis of the donor and recipient aorta). DAo, donor aorta; DLV, donor left ventricle; DPA, donor pulmonary artery; RAo, recipient aorta; RPA, recipient pulmonary artery; RRA recipient right atrium; RRV recipient right ventricle.




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