Paroxysmal supraventricular tachycardia initiated by ventricular couplets in concealed ventricular trigeminy.

A case report of a man with ventricular concealed trigeminy in whom ventricular couplets initiating paroxysmal supraventricular tachycardia were occasionally seen is reported. This is the first report on concealed trigeminy with couplets. This strengthens the authors' previous suggestion that supernormal conduction may occur in the reentrant pathway of extrasystoles, as a mechanism of ventricular couplets.