2:1 Pulsus and electrical alternans during atrioventricular reciprocating tachycardia in a healthy young man: A case report

Pulsus alternans (PA) is a hemodynamic phenomenon characterized by a beat-to-beat alternation in pulse amplitude that results in a clinically appreciable pulse rate half of the electrical rate. It was first described in 1872 by Traube1 and many theories have been postulated regarding its pathophysiology. PA is usually associated with severe heart disease and can eventually result in pulseless electrical activity.2–4 It has rarely been described in healthy individuals. In contrast, electrical alternans (EA) is defined by alternating QRS amplitudes on an electrocardiogram.