Corresponding author:
Amdreas Müssigbrodt, M.D., FESC, FEHRA
Département de Cardiologie, Centre Hospitalier Universitaire de Martinique, BP 632, 97200 Fort de France, Martinique.
E-Mail: andreas.muessigbrodt@gmail.com
Telephone: +596 596 55 20 00
Manuscript type: Video Case
Conflict of interest: None
Total manuscript word count: 97 (excluding title page and references)
Case Presentation:
A 79-year-old female presented with episodes of vertigo and palpitations. A notable ”frog sign” was observed, characterized by prominent cannon A waves in the jugular and subclavian veins due to atrial contraction against a closed tricuspid valve. Cannon A waves are typically seen in AVNRT and less commonly in other supraventricular arrhythmias, tricuspid regurgitation, ventricular tachycardia, complete heart block, and pacemaker syndrome (1,2). The ECG revealed a regular, narrow-complex tachycardia without visible P-waves, raising suspicion for AVNRT. The diagnosis was confirmed by an electrophysiological study, and radiofrequency ablation was performed successfully. During follow-up, no further symptoms were reported.
References:
1. González‐Casal D, Pérez‐Castellanos A, Flores NS, Carta‐Bergaz A, González‐Torrecilla E, Bruña Fernández V, et al. Cannon A wave validation as a diagnostic tool in paroxysmal supraventricular tachycardias. Pacing Clinical Electrophis. mars 2024;47(3):383‑91.
2. Ho C, Ho R. The Frog Sign Revisited. J Innov Cardiac Rhythm Manage. 1 oct 2022;13(10):5184‑7.