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Case Reports
. 2022 Oct 15;13(10):5184-5187.
doi: 10.19102/icrm.2022.13101. eCollection 2022 Oct.

The Frog Sign Revisited

Christopher J Ho  1 , Reginald T Ho  2
Affiliations
Case Reports

The Frog Sign Revisited

Christopher J Ho et al. J Innov Card Rhythm Manag. .

Abstract

The frog sign is a classic physical examination finding of typical atrioventricular nodal re-entrant tachycardia. We present the case of a 78-year-old man with recurrent, symptomatic supraventricular tachycardia referred for ablation in whom the frog sign was observed during physical examination.

Keywords: Frog sign; right atrial pressure; typical atrioventricular nodal re-entrant tachycardia.

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Conflict of interest statement

The authors report no conflicts of interest for the published content. No funding information was provided.

Figures

Figure 1:
Figure 1:
Twelve-lead electrocardiogram of supraventricular tachycardia.
Figure 2:
Figure 2:
Onset (A) and termination (B) of typical atrioventricular nodal re-entrant tachycardia with right atrial pressure (RAP) recordings. The positive a-wave represents atrial contraction that actively fills the right ventricle in end-diastole. The positive c-wave results from the closure and bulging of the tricuspid valve into the right atrium during early systole. The positive v-wave reflects a passive increase in RAP as the right atrium fills in late systole and early diastole. The x descent reflects atrial relaxation in the final phase of ventricular systole. The y descent results from the opening of the tricuspid valve and passive ventricular filling in early diastole. Abbreviations: CS, coronary sinus; HRA, high right atrium; RAP, right atrial pressure; RV, right ventricle; VA, ventriculoatrial. *His-refractory atrial premature depolarization.
Figure 3:
Figure 3:
Onset (A) and termination (B) of entrainment of typical atrioventricular nodal re-entrant tachycardia from the ventricle with right atrial pressure recordings. Abbreviations: ↓, atrial pressure waveforms dissociated from ventricular waveforms; CS, coronary sinus; HRA, high right atrium; RAP, right atrial pressure; RV, right ventricle; VA, ventriculoatrial.
See this image and copyright information in PMC

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