A 16-Year-Old Previously Healthy Boy Is Brought to the Office

A 16-year-old previously healthy boy is brought to the office due to palpitations.  He was watching a documentary at a movie theater when his heart suddenly began to race and he became lightheaded.  The patient says that he has felt "rapid heartbeats" in the past and thought that they were due to stress from school exams, but he has never had associated lightheadedness before.  He has no chest pain or dyspnea.  Physical examination is within normal limits.  ECG strip is shown in the exhibit.  Which of the following is most likely to be seen in this patient?

A) Atrioventricular conduction tract bypassing the atrioventricular node
B) Cardiac myocyte degeneration below the level of the atrioventricular node
C) Ectopic atrial foci that serve as the dominant pacemaker
D) Prolonged repolarization due to myocyte ion channel abnormality
E) Rapid electrical impulses originating in the pulmonary veins

Correct Answer:

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