{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:27:38Z","timestamp":1753878458637,"version":"3.41.2"},"reference-count":7,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We describe a patient who underwent AV node modification to create complete heart block in the setting of incessant, ablation\u2010and\u2010drug\u2010refractory, symptomatic atypical atrial flutter. His dual chamber defibrillator (previously implanted for resuscitated cardiac arrest) was programmed to the VVIR mode at a faster pacing rate of 85\u2009bpm. Serendipitously, this rate was an almost exact factorial of his flutter rate of 250\u2013260\u2009bpm. This resulted in every 6th flutter wave falling in the supernormal period, resulting in fixed\u2010coupled supraventricular bigeminy and trigeminy in the setting of complete heart block. Reprogramming the pacing rate to 75\u2009bpm abolished bigeminy and trigeminy.<\/jats:p>","DOI":"10.1111\/anec.70069","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T05:28:38Z","timestamp":1743744518000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serendipitous Supernormality"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1240-7812","authenticated-orcid":false,"given":"Behzad B.","family":"Pavri","sequence":"first","affiliation":[{"name":"Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eitan","family":"Frankel","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"247","volume-title":"Electrocardiograph of Arrhythmias","author":"Fisch C.","year":"1990"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(68)90299-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(71)90240-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(73)90269-5"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12413"},{"key":"e_1_2_7_7_1","first-page":"37","article-title":"Supernormal Recovery Phase, Illustrated by Two Clinical Cases of Heart Block","volume":"11","author":"Lewis T.","year":"1924","journal-title":"Heart"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1993.tb01234.x"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.70069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T08:06:17Z","timestamp":1748333177000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.70069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":7,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/anec.70069"],"URL":"https:\/\/doi.org\/10.1111\/anec.70069","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"type":"print","value":"1082-720X"},{"type":"electronic","value":"1542-474X"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"assertion":[{"value":"2025-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70069"}}