Permanent atrial paralysis

A forty-four year old female presented with hemiparesis a slow supraventricular rhythm without "P" wave activity and was subsequently found to have atrial paralysis. On treadmill exercise testing the patient's heart rate increased to 118/min. It is felt that this most likely represents sinus rhythm with sinoventricular conduction and that the slow resting heart rate is secondary to a sick sinus node syndrome.