A 54-year-old female with mental retardation presented to the emergency department with a recurrent supraventricular tachycardia (SVT) at 180 bpm. An electrophysiology (EP) study was performed. The baseline rhythm was sinus rhythm without ventricular preexcitation. Her clinical tachycardia was induced when an atrial extrastimulus was delivered with a coupling interval of 340 ms during a drive train with a cycle length (CL) of 550 ms (Fig. 13.1). There was a one-to-one relationship between the atrium and the ventricle. The ventriculoatrial (VA) interval associated with the first beat of the tachycardia is nearly identical to the remaining VA intervals. Can atrial tachycardia be excluded?
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