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. 2020 Nov 3;11:5555. doi: 10.1038/s41467-020-19304-9

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 9 — a, b Telemetric ECG trace (top) and corresponding arterial blood pressure recordings (bottom) from a male HCN4FEA mouse during IAVD. Characteristic flirtatious P waves indicate the presence of two independent pacemakers (top and inset). Concomitantly with the successive decrease in PR intervals, blood pressure dropped (bottom). b (top and inset) The P wave is hidden within the QRS complex, located behind or before the QRS complex. Blood pressure starts to normalise when PR normalises (bottom). c Number of IAVD episodes during 3 h in low activity phase (n = 11 HCN4FEA animals). d OAPs and surface ECG recorded from a female HCN4FEA whole-heart preparation during IAVD. e (left) Activation maps of beat #1 determined from the recordings presented in d showing IAVD ex vivo. Activation maps for beats 1, 2, 3, and 5 were similar. Right: activation map of beat #4. f Ladder diagrams for beats #1–5. Beat #1 and 3: normal activation arising from SAN with regular and constant PR; beat #2, 4, and 5: IAVD with shortened or negative PR indicating that the atria are activated by SAN and ventricles by a subsidiary pacemaker close to the AV junction. Schematic ladder diagrams were determined from the measurements shown in d, e. Boxplots show the median line, perc 25/75, and min/max value; open symbols represent the mean value. Source data are provided as a Source Data file.